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GROUP HEALTHBENEFITS

for employees of

CAPRON COMPANY, INC.

IMPORTANT HIGHLIGHTS

(1) This Capron Company, Inc. Health Care Plan believes this plan is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on essential benefits. Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to the plan administrator. You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform.

(2) MANDATORY HOSPITAL PRE-CER TIFICATION YOU MUST OBTAIN PRE-CERTIFICATION FOR HOSPITAL ADMISSIONS AND CERTAIN SURGICAL/DIAGNOSTIC PROCEDURES. Refer to the Pre-Admission Review and Surgical/Diagnostic Review Provisions of this Summary Plan Description.

(3) YOU MUST NOTIFY THE HUMAN RESOURCES DEPARTMENT WHEN ONE OF THE FOLLOW ING EVENTS OCCUR. Birth of child. Your covered child turns 19 26. (Coverage will terminate for this child if

he/she is not a full-time student). Your covered full-time student graduates, quits school or turns age 22. Divorce or marriage Adoption of child. Death of the Covered Person.

Failure to notify the Human Resources Department of these events could result in loss of eligibility and claims being denied.

(4) YOU MUST BE SURE ALL PROVIDERS HAVE CURRENT BILLING INSTRUC-TIONS PROVIDED ON YOUR IDENTIFICATION CARD. FAILURE TO SUBMIT CLAIMS PROPERLY WILL RESULT IN DELAYED CLAIMS PROCESSING.

(5) BILLS SHOULD BE SUBMITTED FOR PAYMENT IN A TIMELY BASIS. Claims filed more than 12 months after the date of service will not be eligible for payment.

http://www.dol.gov/ebsa/healthreform

Important InformationAbout Your Plan

The CAPRON COMPANY, INC.Group Number

FCAPR

Forward all OneNet PPO/MAPSI Network Claims to:

(OneNet PPO was formerly known as the Alliance PPO)

To locate OneNet PPO Providers Call 1-800-342-3289 or use

www.onenetppo.com

Send OneNet PPO claims to:

OneNet PPOP.O. Box 934

Frederick, MD 21705

Forward all Non-Network Claims to: The Loomis Company/Benefits DivisionP.O. Box 7011

Wyomissing, PA 19610-6011

Forward all Dental Claims to: The Loomis Company/Benefits DivisionP.O. Box 7011

Wyomissing, PA 19610-6011

To Verify Eligibility, Benefits and Payment of Claims

Telephone The Loomis Company at 1-800-346-1223

For Non-Emergency and EmergencyHospital Admissions

Telephone Hines & Associates at 1-888-826-5769

Locate Express Scripts Pharmacies Telephone 1-800-451-6245

http://www.mamsi.com/

UTILIZATION REVIEW REQUIREMENTSPlease Read Carefully

HOSPITAL CERTIFICATION

IN-PATIENT HOSPITALIZATION AND SURGERY, OUTPATIENT SURGERY, AND SOME OUTPATIENT PROCEDURES MUST BE PRE-CERTIFIED OR BENEFITS WILL BE REDUCED BY $250. FOR NON-EMERGENCY HOSPITALIZATION, CERTIFICATION SHOULD BE MADE 7 DAYS IN ADVANCE OF ADMISSION. FOR EMERGENCY HOSPITALIZATION, CERTIFICATION SHOULD BE MADE WITHIN 48 HOURS AFTER ADMITTANCE. CALL HINES & ASSOCIATES AT1-888-826-5769 FOR CERTIFICATION.

SECOND OPINION FOR SURGERY

THERE ARE CERTAIN SURGICAL PROCEDURES THAT REQUIRE A SECOND OPINION OR THE SURGEON'S FEE WILL BE REDUCED BY $250. THE PATIENT OR PHYSICIAN MUST CALL TO OBTAIN THE SECOND OPINION IN ADVANCE OF SURGERIES. CALL HINES & ASSOCIATES AT 1-888-826-5769 FOR ASSISTANCE.

BABE MATERNITY PROGRAM

IN ADDITION TO THE STANDARD HOSPITAL CERTIFICATION REQUIREMENTS, YOU SHOULD NOTIFY HINES & ASSOCIATES AT 1-888-826-5769 UPON CONFIRMATION OF YOUR PREGNANCY BY YOUR DOCTOR. CALL HINES & ASSOCIATES TO SPEAK TO A MATERNITY CARE SPECIALIST WHO WILL ENROLL YOU IN THE BABE PROGRAM AND PROVIDE YOU WITH ADDITIONAL INFORMATION. PRE-CERTIFICATION REQUIREMENTS FOR ANY IN-PATIENT HOSPITALIZATION WILL STILL APPLY TO ANY HOSPITAL ADMISSION DURING YOUR PREGNANCY. CALL HINES & ASSOCIATES AT 1-888-826-5769 FOR ASSISTANCE.

IMPORTANT INFORMATION ABOUT YOUR PLAN(SUMMARY PLAN DESCRIPTION)

This Summary Plan Description has been compiled in accordance with Public Law 93-406 (known as the EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974; "ERISA”).

NAME OF PLAN The CAPRON COMPANY, INC.Employee Medical Plan

ADDRESS OF PLAN 411 North Stonestreet Avenue Rockville, MD 20850

ORIGINAL PLAN EFFECTIVE DATE June 1, 1993June 1, 2011 (as restated)

FISCAL YEAR OF PLAN June 1st through May 31st

TYPE OF BENEFITS Self-Funded Medical, Dental & Prescription Card Service

PLAN NUMBER 501K

EMPLOYER (PLAN SPONSOR) IDENTIFICATION NUMBER

52-1047768

PLAN ADMINISTRATOR AND AGENT FOR LEGAL PROCESS

Kay Hirsch, CMA

GROUP NUMBER FCAPR

TYPE OF ADMINISTRATION Third Party Administrator

BENEFIT SERVICES MANAGEMENT (THIRD PARTY ADMINISTRATOR)

The Loomis CompanyP.O. Box 7011Wyomissing, PA 19610-6011(610) 374-4040 or 1-800-346-1223

PLAN WAITING PERIOD

A. Employees and Dependents covered on the original Effective Date:

B. Employees and Dependents eligible after the original Effective Date:

None

First day of the month following 30 days of employment.

DEFINITION OF AN ELIGIBLE EMPLOYEE

Full-time Employee regularly scheduled to work at least 35 hours per week.

DEFINITION OF AN ELIGIBLE DEPENDENT

Spouse or Child(ren) of an Employee

DEPENDENT CHILDREN’S COVERAGE

Medical Plan Coverage begins:

A. For Major Medical Benefits – at birth.

B. Continues to age 19, if the dependent is not a full-time student.

C. Continues to age 22, if the dependent is a full-time student.

D. Continues indefinitely if the dependent is totally and permanently disabled or incapacitated when his coverage would otherwise terminate.

CONTRIBUTIONS TO THE PLAN A. The employee is required to pay a portion of the cost of the employee coverage, and/or

B. The employee is required to pay a portion of the cost of the dependent coverage.

CAPRON COMPANY, INC. HEALTH CARE PLANTABLE OF CONTENTS

INTRODUCTION..............................................................................................................2MEDICAL EXPENSE BENEFIT PROVISION...................................................................3MENTAL/NERVOUS & ALCOHOL/SUBSTANCE ABUSETREATMENT..........................4PARTIAL HOSPITALIZATION..........................................................................................4SCHEDULE OF BENEFITS.............................................................................................5

MEDICAL BENEFITS............................................................................................5DENTAL BENEFITS............................................................................................11

COST CONTAINMENT PROGRAM...............................................................................13ALTERNATIVE CARE....................................................................................................13PRE-ADMISSION REVIEW...........................................................................................14SURGICAL/DIAGNOSTIC REVIEW..............................................................................15LARGE CASE MANAGEMENT......................................................................................16ELIGIBILITY PROVISIONS............................................................................................17COVERAGE FOR EMPLOYEES AND DEPENDENTS OVER THE AGE OF 65...........22TERMINATION OF BENEFITS......................................................................................23TERMINATION DUE TO DISABILITY............................................................................22TERMINATION DUE TO LAYOFF/REDUCTION IN HOURS.........................................22FAMILY AND MEDICAL LEAVE ACT.............................................................................23MILITARY LEAVE ACT...................................................................................................23CLAIM FORM PROCEDURE.........................................................................................25PPO CLAIMS PROCEDURE.........................................................................................25NON-NETWORK CLAIMS PROCEDURE.....................................................................25CLAIMS APPEAL PROCESS.........................................................................................27PRE-EXISTING CONDITIONS LIMITATIONS...............................................................29COVERED MEDICAL EXPENSES.................................................................................31

ORGAN TRANSPLANTS....................................................................................34HOME HEALTH CARE EXPENSES....................................................................35HOSPICE CARE BENEFITS...............................................................................36MATERNITY BENEFITS.....................................................................................37PREVENTIVE CARE...........................................................................................38

PRESCRIPTION DRUG EXPENSE BENEFIT...............................................................39MEDICAL EXCLUSIONS AND LIMITATIONS................................................................42DENTAL PLAN BENEFITS............................................................................................45DENTAL PLAN LIMITATIONS.......................................................................................50COORDINATION OF BENEFITS PROVISION..............................................................51CONTINUATION OF COVERAGE.................................................................................56DEFINED TERMS..........................................................................................................59GENERAL PROVISIONS...............................................................................................65RIGHTS AND PROTECTIONS......................................................................................67IMPORTANT FACTS......................................................................................................73

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LE 08/09/2011

INTRODUCTION

The following information describes the benefits available to employees of Capron Company, Inc. regularly scheduled to work full-time. When you become covered under this Plan, you will have available to you a listing of the participating hospitals and physicians of the Preferred Provider Organization (PPO). Your Human Resources Department will be able to advise you on a routine basis of the changes in providers who belong to the PPO. If you live within the geographic service area of a PPO and utilize the services of PPO providers, the Capron Company, Inc. Health Care Plan will provide higher levels of benefits to you.

The participating hospitals and physicians of the PPO have agreed to extend a discount to those employees and covered dependents that utilize their facilities. When your claims are processed, you will see the amount of the discount on the Explanation of Benefits. This, of course, helps reduce your liability for the cost of the services.

One of the advantages of the PPO to you, as a consumer of medical care, deals with the determination of what charges are acceptable for benefit payment. As defined later in this booklet, Covered Expenses will be considered for benefits only up to the reasonable and customary charge for the geographic area in which the service is rendered. This means that if a PPO physician bills an amount in excess of the reasonable and customary amount, you cannot be billed for the excess charge. This provision of the Plan can be meaningful and offers additional financial benefits when PPO providers are used for medical care.

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MEDICAL EXPENSE BENEFIT PROVISION

The Capron Company, Inc. Health Care Plan (the "Plan") has been designed to provide all eligible employees and covered eligible dependents with a program of Health Care Protection. The benefit plan is based on the calendar year. Deductibles are calculated based on expenses incurred during the 12 months of each calendar year.

Deductibles: A deductible is the amount of covered expenses which must be paid each calendar year by Covered Persons before the Plan will consider expenses for reimbursement. The individual deductible applies separately to each Covered Person. The family deductible applies collectively to all Covered Persons in the same family. When the family deductible is satisfied, no further deductible will be applied for any covered family member during the remainder of the calendar year.

Out-of-Pocket Maximums: An out-of-pocket maximum is the amount of covered expenses that must be paid during a calendar year before the payment percentage of the Plan increases. The individual out-of-pocket maximum applies separately to each Covered Person. When a Covered Person reaches the annual out-of-pocket maximum, the Plan will pay 100% of additional covered expenses for the individual during the remainder of the calendar year.

The family out-of-pocket maximum applies collectively to all Covered Persons in the same family. When the annual family out-of-pocket maximum is satisfied, the Plan will pay 100% of covered expenses for any covered family member during the remainder of the calendar year.

Common Accident Provision: In the event of two or more members of one family covered by this Plan become involved in the same accident, and, as a result of injuries incur covered expenses, only one deductible amount shall be deducted from the total covered expenses incurred by those family members.

Multiple Birth Provision: In the event of a multiple birth situation, where two or more children are born to one family at the same time and covered expenses are incurred, only one deductible amount will be deducted from the total covered expenses within the first 30 days of birth.

After the satisfaction of the applicable deductible as described in the Schedule of Benefits, additional covered expenses are generally reimbursed at 90% for PPO providers and 80% for Non-Network providers up to the out-of-pocket maximum as described in the Schedule of Benefits, and generally increase to 100% thereafter. The benefit percentage may be modified under the Pre-Admission Review and Surgical/Diagnostic Review Provision. The lifetime annual maximum benefit available to any covered person for medical coverage is $2,000,000.

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MENTAL/NERVOUS & ALCOHOL/SUBSTANCE ABUSE TREATMENT

If a Covered Person incurs expenses in connection with care or treatment of mental illness or functional nervous disorders, or for care or treatment of alcoholism or substance abuse, benefits are available as specified in the Schedule of Medical Benefits for covered expenses incurred in a hospital or specialty care facility.

When not confined, charges for outpatient mental nervous or functional disorder treatment or charges for outpatient substance abuse treatment by a licensed professional (includes licensed clinical social worker, L.C.S.W.) shall be covered as specified in the Schedule of Medical Benefits.

Any confinements to hospitals or other institutions treating mental illness or functional nervous disorders require pre-authorization from the Utilization Review Manager.

PARTIAL HOSPITALIZATION

If a Covered Person incurs expenses for Partial Hospitalization as a result of Mental/Nervous/Alcohol/Substance Abuse, the Plan will pay for each day of confinement as follows:

Benefits payable are subject to the same conditions as for Inpatient Mental/Nervous/Alcohol/Substance Abuse treatment; and

Partial hospitalization must be a medically necessary alternative to Inpatient hospitalization and is designed for patients who do not require 24-hour care, but who would benefit from more intensive treatment than ordinarily offered on an outpatient basis.

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CAPRON COMPANY, INC.SCHEDULE OF MEDICAL BENEFITS

Original Effective Date: July 1, 1998Updated: June 1, 2010

Maximum Lifetime Annual Benefit for Medical Care $2,000,000

PPOProvider Network

Non-NetworkBenefit Plan

Calendar Year Deductible Transferable in- or out-of-network.

$300 per person$600 per family

$300 per person$600 per family

Calendar Year Co-InsuranceMedical Plan PaysPatient Pays

90%10%

80%20%

Co-InsuranceOut-of-Pocket Maximum (after deductible) for Medical Care.Transferable in- or out-of-network.

$ 500 per person$1,000 per family

$ 500 per person$1,000 per family

Co-insurance amounts paid for non-compliance with managed care procedures do not accumulate toward the annual out-of-pocket maximum.

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BENEFITS AND SERVICESPPO

PLAN PAYS(AFTER DEDUCTIBLE)

NON-NETWORK PLAN PAYS

(AFTER DEDUCTIBLE)Hospital Benefit IIn-Patient Medical or Surgical Care Hospital benefits reduced by $250

unless pre-certified.

90% of Allowable Expense 80% of UCR* Charge

Hospital Benefit II In-patient Mental/Nervous Care In-patient

Hospital benefits will be reduced by $250 unless pre-certified.

Partial Hospitalization

90% of Allowable Expense


80% of UCR* Charge

80% of UCR* ChargeHospital Benefit II In-patient Substance Abuse Care In-patient

Includes Detoxification Hospital benefits will be reduced by $250 unless pre-certified.

Partial Hospitalization



80% of UCR* Charge

80% of UCR* ChargeOutpatient Mental/Nervous and/or Substance Abuse Benefit

100% 90% of Allowable Expense after a $30 Co-pay

per visit

80% of UCR* Charge

Hospital Emergency Room Sickness Care (within 72 hours after the occurrence) Emergency Room fee

Physician’s fee

Miscellaneous charges related to visit




80% of UCR* Charge

80% of UCR* Charge

80% of UCR* Charge

Emergency Room Care for Accident or Sudden Serious Illness(within 72 hours after the occurrence)First $300 covered at 100%, then: Physician’s fee

Other services



80% of UCR* Charge

80% of UCR* ChargeHospital Pre-Admission X-Ray and Laboratory Testing For X-Ray and lab test performed

prior to confinement.100% of Allowable Expense** 100% of UCR* Charge

Hospice Benefits 180 days per lifetime. Must be

certified by a physician as medically necessary.


Convalescent/Extended Care and Skilled Nursing Facility Combined benefit of 90 days per

year, must begin within five days after a hospital confinement.


Surgical Benefit I In-patient Surgical Charges 90% of Allowable Expense 80% of UCR* Charge

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(AFTER DEDUCTIBLE)including Anesthesia

Certain surgeries require a second opinion or the surgeon’s benefit will be reduced by $250.

Surgical Benefit II Outpatient Surgical Charges

including Anesthesia. Certain surgeries require a second

opinion or the surgeon’s benefit will be reduced by $250.


Surgical Benefit III Ambulatory Surgical Center or

Outpatient Facility charges related to Outpatient surgery.


Second Surgical Opinion Certain types of surgery require a

second opinion or the surgeon’s benefit will be reduced by $250.

100% of Allowable Expense**

100% of UCR* Charge**

Oral Surgery Benefits outlined in Basic Dental

Services Section.As any other surgical

expenseAs any other surgical

expenseDoctor’s Visits Covers physician’s visits and

consultations Hospital Office

Specialist

100% of Allowable Expense100% of Allowable Expense after a $10 Co-pay per visit**100% of Allowable Expense after a $30 Co-pay per visit**

80% of UCR* Charge80% of UCR* Charge

80% of UCR* Charge

Home Health Care For eligible services provided by a

licensed home health care agency. Maximum of 90 visits per calendar

year. Each visit is limited to four hours of

service.


Infertility Testing Benefit Maximum payment of $1,000 per

lifetime (combined expenses for both husband & wife).

In-vitro fertilization and artificial insemination.

Treated as any other eligible expense

Not Covered

Treated as any other eligible expense

Not Covered

Maternity Benefit Hospital Charges Doctor Charges

Hospital Newborn Nursery Services Routine physician services

Routine hospital services

90% of Allowable Expense90% of Allowable Expense

100% of Allowable Expense after a $10 co-pay**


80% of UCR* Charge80% of UCR* Charge

80% of UCR* Charge

80% of UCR* ChargePrivate Duty Nursing For services rendered by an RN,

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(AFTER DEDUCTIBLE)LPN, PHN or LVN. 90% of Allowable Expense 80% of UCR* Charge

Birthing Center Services rendered by a birthing

center and/or certified nurse midwife.


Elective Sterilization Covered as a surgical benefit. The

reversal of sterilization is not an eligible benefit.

As any other covered expense

As any other covered expense

Diagnostic X-Ray and Laboratory For services performed on an

Outpatient basis.90% of Allowable Expense 80% of UCR* Charge

Chemotherapy and Radiation Therapy Covered Outpatient services. 90% of Allowable Expense 80% of UCR* ChargeChiropractic Benefit Maximum payment of $1,000 per

calendar year.90% of Allowable Expense 80% of UCR* Charge

Temporomandibular Joint Dysfunction (TMJ) and Myofascial Pain Dysfunction (MPD) Maximum payment of $1,000 per

lifetime.90% of Allowable Expense 80% of UCR* Charge

Prescription Drug Card Benefit Benefits available with Drug ID

card or Mail Order Plan. Oral Contraceptives are covered.

100% after a deductible of:$ 5 Generic drugs

$10 Preferred Name Brand drugs$20 Non-Preferred Name Brand drugs

$4 mail order drugsPreventive/Wellness Care Services Well child care including routine

testing and immunizations. Maximum payment of $300 per Covered Person per calendar year.

Adult routine preventive care including examinations, immunizations, and routine testing. Maximum payment of $300 per Covered Person per calendar year. (This benefit also includes routine GYN examinations, PAP tests, mammograms, and routine prostate exams.)

100% of Allowable Expense after $10 co-pay per visit**

100% of Allowable Expense after $10 co-pay per visit**

80% of UCR* Charge

80% of UCR* Charge

Acupuncture Benefit Maximum of $1,000 per calendar

year.90% of Allowable Expense 80% of UCR* Charge

Allergy Injections 90% of Allowable Expense 80% of UCR* ChargeDurable Medical Equipment Medically necessary equipment or

supplies.90% of UCR Charge when

ordered by a Preferred Provider

80% of UCR* Charge

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(AFTER DEDUCTIBLE)Ambulance 90% of Allowable Expense 80% of UCR* Charge

Other Covered Benefits 90% of Allowable Expense 80% of UCR* Charge

*UCR means Usual, Customary and Reasonable Charges. **Annual Deductible does not apply.

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SCHEDULE OF DENTAL BENEFITS

BENEFIT MAXIMUM PAYMENT

A Annual Maximum - Levels I, II, III $1,000

B Lifetime Maximum - Level IV $1,500

C Deductible, per year for Levels II and III Benefits Combined (Deductible waived for Level I and IV Benefits below)

$50 per person

D Co-Insurance Level I - Preventive Dental Services Level II - Basic Dental Services Level III - Major Restorative and Prosthodontic

Services Level IV - Orthodontic Services

Plan pays 100% UCR*Plan pays 80% of UCR*Plan pays 50% of UCR*

Plan pays 50% of UCR*

*UCR means Usual, Customary and Reasonable Charges.

12

COST CONTAINMENT PROGRAM

Capron Company, Inc. desires to provide you and your family with a health care plan that financially protects you from significant health care expenses and assists you in locating quality care. While part of increasing health care costs results from new technology and important medical advances, another significant cause is the way health care services are used.

Some studies indicate that a significant percentage of the health care services rendered may be unnecessary. For example, hospital stays can be longer than necessary. Some hospitalization may be entirely avoidable, such as, when surgery could be performed on an Outpatient basis with equal quality and safety. Also, surgery is sometimes performed when other treatment could be more effective. Unnecessary or avoidable health services increase costs for you and Capron Company, Inc.

Capron Company, Inc. contracts with a professional utilization review manager to assist you in determining whether or not proposed services are appropriate for reimbursement under the Plan. The program is not intended to diagnose or treat medical conditions, guarantee benefits, or validate eligibility. The medical professionals who conduct the program focus their review on the appropriateness of hospital stays and proposed surgical and ambulatory procedures.

ALTERNATIVE CARE

In addition to the benefits specified in this booklet, the Plan may elect to offer benefits for services furnished by any Provider pursuant to an alternate treatment plan approved by the Plan and/or the utilization review manager for a Covered Person whose condition would otherwise require hospital care.

The Plan shall provide such alternative benefits for as long as the services are medically necessary and cost effective as determined by the Plan and/or utilization review manager. The total benefits paid for such services will not exceed the total benefits for which the Plan would have paid under this Plan in the absence of alternative benefits.

If the Plan elects to provide alternative benefits for a Covered Person in one instance, it shall not be obligated to provide the same or similar benefits for other Covered Persons under the Plan in any other instance. Nor shall it be construed as a waiver of the Benefit Services Manager’s right to administer the Plan thereafter in strict assurance with its express terms.

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PRE-ADMISSION REVIEWThe Capron Company, Inc. Health Care Plan provides pre-admission review programs through Utilization Review Manager identified on your health plan ID cards.

If a physician recommends hospitalization for any Covered Person, a call must be made to the Utilization Review Manager. This program must be utilized for maximum benefits to be provided under the terms of the Capron Company, Inc. Health Care Plan.

Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the Plan or the issuer for prescribing a length of stay less than 48 hours (or 96 hours). However, this does not preclude a Plan or issuer from requiring pre-notification for any portion of a stay after 48 hours (96 hours), or from requiring pre-notification for the entire stay.

If a Covered Person is confined on an elective, non-emergency basis without utilizing this program, a $250 penalty will be applied. This penalty cannot be used to satisfy remaining deductible or co-insurance payments due from the Covered Person. In the case of an emergency admission, a contact to the Utilization Review Manager must be made within 48 hours of confinement. Their office can be reached by dialing the phone numbers identified on your health plan I.D. cards.

After the initial contact by the covered employee or dependent is made, all remaining communication in the review process will be between the Utilization Review Manager and your physician. Upon completion of the review process, the Utilization Review Manager will advise you of their recommendation. If a patient will be confined for a period longer than originally certified, contact to the Utilization Review Manager must be made by the physician. Charges in excess of the approved treatment plan or for a period beyond an approved and pre-certified length of stay will be denied if the confinement was determined not medically necessary by the Utilization Review Manager.

When a confinement for the treatment of a mental/nervous condition or a drug or alcohol-related condition is recommended, a call to the Utilization Review Manager must be made or a $250 penalty will be applied.

When a Covered Person is admitted to a hospital for a non-emergency elective confinement and the pre-admission program is not followed, benefits payable will be reduced as explained above. No part of the charges that are not reimbursed because of this section will be eligible for consideration as deductible or out-of-pocket maximum amounts.

Required Second Surgical Opinion – At any time during the review process, the Covered Person may be asked to obtain a second surgical opinion to confirm the necessity for surgery. If the second opinion disagrees with the first opinion, a third surgical opinion will be required. Second and third surgical opinions will be given by a physician who is certified by the American Board of Medical Specialists in a field related to the proposed surgery. The physician giving the opinion will also be independent of the physician who first advised surgery.

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SURGICAL/DIAGNOSTIC REVIEW

If a physician recommends the following care, surgical and/or diagnostic procedures, a call to the Utilization Review Manager is required. If the Utilization Review Manager is not notified of the following procedures, a $250 penalty will be applied. (No part of the penalty will be eligible for consideration as deductible or out-of-pocket maximum amounts.)

1. All in-patient surgery;2. All Outpatient surgery;3. Any confinements to hospitals or other institutions treating mental/nervous

disorders, and alcohol/substance abuse.

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LARGE CASE MANAGEMENT

When a catastrophic condition occurs, such as a spinal cord injury, a degenerative sickness, or a neurological paralytic disease, a person will require long-term, perhaps lifetime care. After the person’s condition is stabilized in the hospital, he or she might be able to be moved out of the hospital and into another type of care setting – even to his or her home.

Sometimes, specialized care or adaptations to the home are required, but are not covered under the Plan. The Large Case Management program was initiated for those situations in which there could be a large cash outlay for non-Covered Expenses for catastrophic conditions, and if appropriate to approve less expensive alternatives that might not otherwise be covered.

Large Case Management occurs in the following situations:

The catastrophic injury or sickness must have occurred while the patient was covered and the injury or sickness must have been covered under the Plan.

The patient has been hospitalized and the attending physician feels the condition is stabilized.

The patient must continue to require an acute level of care, but that care need not be in a hospital.

Moving the patient to the new care setting must entail expenditures that are not reimbursable under the Plan.

The Case Manager will coordinate and implement the Large Case Management program by providing guidance and information on available resources and suggesting appropriate treatment alternatives.

The Plan Administrator, attending physician, patient and patient’s family must all agree to the alternate treatment plan.

Once agreement has been reached, the Plan Administrator will direct the Plan to reimburse for expenses as stated in the treatment plan, even if these normally would not be repaid by the Plan.

NOTE: Large Case Management is a voluntary service. There is no reduction of benefits and no penalties if the patient and family choose not to participate.

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ELIGIBILITY PROVISIONS

If you are an employee of Capron Company, Inc., regularly scheduled to work at least 35 hours per week, you are eligible for coverage under the terms of the Capron Company, Inc. Health Care Plan. The effective date of coverage is the first day of the month following 30 days of employment.

You may obtain coverage for you and your eligible dependents by completing the enrollment form and contributing any required amounts as defined by the Capron Company, Inc. personnel practice. If a husband and wife are employees, they may be covered as employees, but any eligible dependents may be covered as dependents of one parent but not both.

An eligible dependent shall mean any one or more of the following:

1. The lawful spouse of the employee under a legally existing marriage between persons of the opposite sex.

2. Children of the employee, who are under the age of 26 including legally adopted children, children legally placed for adoption, step-children, and foster children, and children for whom the employee and/or the employee’s spouse has been appointed guardian by a court of competent jurisdiction. Coverage for dependent children will be terminated if said dependent child is eligible to receive coverage through his/her employer. In addition, a spouse or biological child of a covered dependent child will not be eligible for coverage under this Plan.

3. Children of the employee, including legally adopted children, children legally placed for adoption, step-children and foster children as defined above who are primarily dependent upon the employee for support and maintenance and who are incapable of self-sustaining employment due to mental or physical disability, provided such disability started before the attainment of age 26. Also, such children must have been covered prior to the attainment of such age and covered continuously thereafter. The Plan Administrator may require proof of the dependents incapacity status. The Plan Administrator reserves the right to have such dependent examined by a physician of the Plan Administrator’s choice, at the Plan’s expense, to determine the existence of such incapacity.

In order to continue a dependent child’s coverage beyond age 26, you must furnish written verification of their incapacity for self-support within 60 days of the child's 26th birthday.

4. Alternate recipients under qualified medical child support orders required to be covered according to the provisions of ERISA Section 609 (a) (2) (A).

A newborn child will automatically be covered for the first 30 days immediately following birth. Such coverage will end 30 days after the birth of the child. If you agree to contribute any required amounts as defined by our personnel practice and complete an enrollment form within the initial 30-day period, coverage on the child may continue.

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ENROLLMENT

Special Enrollment Periods – Special enrollment periods for individuals who do not enroll in the Plan at the first opportunity and subsequently lose coverage must be available in compliance with the Health Insurance Portability and Accountability Act of 1996. Special Enrollment Periods Those individuals who do not enroll in the Plan at the first opportunity and subsequently lose coverage may be able to enroll in the Plan in compliance with the Health Insurance Portability and Accountability Act of 1996. The enrollment date for anyone who enrolls under a special enrollment period is the first date of coverage. Thus, the time between the date a special enrollee first becomes eligible for enrollment under the Plan and the first day of coverage is not treated as a waiting period.

An individual must be allowed to enroll/terminate under the Plan if: The employee or dependent incurs a claim that would meet or exceed a lifetime limit

on all benefits; The employee or dependent had been covered under another group health plan or

had an individual health policy at the time coverage was initially offered; If required by the Plan Administrator, the employee stated at the time initial enrollment

was offered that other coverage was the reason for declining enrollment in the Plan; The individual lost coverage as a result of a certain event, such as the loss of eligibility

for coverage, loss of eligibility due to the Plan no longer offering any benefits to a class of similarly situated individuals (e.g. part-time employees), expiration of COBRA continuation coverage, termination of employment, reduction in the number of hours of employment, or employer contributions towards such coverage were terminated;

A new model notice of special enrollment rights is provided. This notice must be provided on or before the time an employee is initially offered the opportunity to enroll in a group health plan; or

The employee’s or dependent’s Medicaid or State Child Health Insurance Plan (SCHIP) coverage is terminated as a result of loss of eligibility; or

The employee or dependent becomes eligible for a premium assistance subsidy under Medicaid or SCHIP.

The individual must request special enrollment within 30 days of the date coverage is lost, except in the case of a qualifying event involving Medicaid or SCHIP (loss of eligibility or premium assistance eligibility). For these events, the individual must request special enrollment within 60 days of the event.

If the employee or dependent lost the other coverage as a result of the individual’s failure to pay premiums or required contributions or for cause (such as making a fraudulent claim), that individual does not have a special enrollment right.

Dependent Special Enrollment PeriodSince the Plan provides dependent coverage, when a person becomes a dependent through marriage, birth or adoption, the Plan must provide a dependent special enrollment period of not less than 30 days. If an individual seeks to enroll a dependent during the first 30 days, coverage must become effective: In the case of marriage, no later than the first day of the first month beginning after the

date the request was completed.

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In the case of a newborn born to the employee or the employee’s spouse, the date of such birth.

In the case of adoption or placement for adoption by either the employee or the employee’s spouse, the date of such adoption, or placement of adoption.

The date the employee or the employee’s spouse is required to provide health coverage to a child under a Qualified Medical Child Support Order (QMCSO), National Medical Child Support Notice (NMCSN) or administrative order.

The date on which legal guardianship status begins.

If for any reason you do not enroll within 30 days after the termination of coverage or within 30 days after marriage, birth, adoption or placement for adoption, you and your dependents will not be eligible for coverage until the next open enrollment period. The only exception is for special enrollments related to Medicaid or SCHIP (loss of eligibility or gain of premium assistance eligibility), which must be requested within 60 days of the date of the event.

Late EnrollmentIf you or your dependents are not enrolled within 30 days of the date you become eligible, under the terms of this Plan you may only request Plan coverage during the next open enrollment period unless you experience a special enrollment situation as outlined above. However, you will be subject to an 18-month pre-existing exclusion as outlined in the pre-existing conditions provision unless reduced by evidence of creditable coverage.

Election Changes In general, you will not be able to revoke or change your election for a plan year. Federal law generally prohibits you from making any changes to your election that affect the dollar amount or taxability of your payroll contributions, except during open enrollment. However, such changes are permitted if they are needed because of a “change of status” and the election is consistent with the change in status. It is possible to experience a “change in status” event, but not have the change affect your eligibility to participate in this Plan or another plan. In this case you cannot make a change in your election.

Consistency Rule - Requires that the change in status result in the Employee, Spouse or Dependent gaining or losing eligibility for accident or health coverage under either the cafeteria plan or an accident or health plan of the Spouse’s or Dependent’s employer, and that the election change correspond with that gain or loss of coverage.

To revoke your election and make a new election, Human Resources must receive the ap-propriate forms within 30 days of the date of your change of status. If your change in sta-tus occurs with less than 30 days remaining in the plan year, the 30-day requirement will extend into the New Year (however, if you wait until the new year to make your adjust-ments, it can only affect the benefits you have in the new year). No change in your elec-tion will be permitted after this 30-day period. You may change your elections once a year during the annual open enrollment period or within 30 days of the following events. These events are referred to as a “Change in Status”:

Legal Marital Status - Events that change your legal marital status, including marriage, death of spouse, divorce, legal separation or annulment.

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Number of Dependents - Events that change your number of dependents including birth, adoption, placement for adoption or death of dependent. (Note: Gaining or losing a dependent who is not a tax dependent-such as a parent, domestic partner, or child will not be considered an allowable event for an election change.)

Employment Status/Work Schedule - Events that change your employment status or the employment status of your spouse or dependents that effect your eligibility for benefits including termination or commencement of employment, a strike or lockout, a commencement of or return from an unpaid leave of absence or a change in worksite.

Dependent Satisfies or Ceases to Satisfy the Requirements for Dependents - Events that cause your dependents to satisfy or cease to satisfy the requirements for coverage due to attainment of age, or any other similar circumstances.

Residence or Worksite - Events that change your place of residence, the place of residence of your spouse or dependent that effect eligibility for benefits under the Plan.

You may also change your elections within 30 days of the following events:

Cost Changes - If there is an increase or decrease in the cost of a benefit plan, the Plan may automatically change the amount of your premium election to cover the change in cost. If the cost change is a significant increase, you may be allowed to either make a new election of the higher cost or revoke your election, but you must elect similar coverage if available. If the cost change is a significant decrease, you may be allowed to commence participation of the option with a decrease in cost.

Significant Curtailment of Coverage - If your coverage is markedly reduced or eliminated all together you may revoke your election and make a new election for similar coverage under a new benefit package option or drop coverage if no similar benefit package option is available. The loss of a physician in the network would not constitute significant curtailment of coverage.

Addition (or Improvement) of a Plan Option Providing Similar Coverage - If during a period of coverage an option is added to the Plan (or an existing option is significantly improved), you may be allowed to elect the new option (or improved benefit option) prospectively on a pre-tax basis and change your election with respect to the other benefit option providing similar coverage.

Change in Coverage of Spouse or Dependent Under Another Employer Plan - You may make an election change that is on account of and corresponds with a change in coverage under another employer plan (including a plan of the same employer or a plan of the spouse’s or dependent’s employer) if one of two conditions are met (a) the other Plan must permit participants to make an election change; or (b) the period of coverage under the employee’s Plan is different from the period of coverage under the other employer plan.

Loss of Other Health Coverage - You may make an election to add coverage under the Plan if you or your covered dependent(s) loses coverage under any group health coverage sponsored by a governmental or educational institution.

FMLA Leave - You may change an election under the Plan upon FMLA and non-FMLA leave.

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Exception for COBRA Qualifying Events - If you, your spouse or dependent gains or loses coverage due to a COBRA qualifying event, you may change your election to pay for the continuation of coverage on a pre-tax basis or to reduce your election for the corresponding loss of coverage.

Judgment, Decree or Order - If there is a judgment, decree or order resulting from a divorce, legal separation, annulment or change in legal custody that requires a change in accident or health coverage for your dependent child, you may make an election change to add or drop coverage as ordered.

Entitlement to Medicare - If you, your spouse or dependent becomes entitled to Medicare, you may make a prospective election change to cancel health coverage under this Plan. If you, your spouse or dependent loses coverage under Medicare, you may make a prospective election to begin or increase coverage under this Plan.

HIPAA Special Enrollment Rights - If you gain the right to enroll in this Plan or to add coverage for a family member under the special enrollment rights of HIPAA, the Covered Person may revoke an election for coverage during a period of coverage and make a new election.

You may also change your elections within 60 days of the following events: Entitlement to Medicaid or SCHIP – If you, your spouse or dependent becomes

entitled to Medicaid or SCHIP (premium assistance eligibility), you may make a prospective change to cancel health coverage under this Plan. If you, your spouse or dependent loses coverage under Medicaid or SCHIP, you may make a prospective election to begin or increase coverage under this Plan.

If you make a change in election, your new election amount will be effective the date of the qualifying event.

Open Enrollment Period Every May 1st through May 31st is the annual Open Enrollment Period. During this time employees will be eligible to change some of their benefit decisions based on which benefits and coverage are right for them.

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COVERAGE FOR EMPLOYEES AND DEPENDENTS OVER THE AGE OF 65

If you, as a regularly scheduled and covered employee, or your covered spouse are beyond age 65, you have a choice regarding your primary health care coverage. You may elect to continue coverage for yourself, your spouse and other dependents under the Capron Company, Inc. Health Care Plan. If you choose to remain covered under this Plan, this Plan will be the primary payer of benefits and Medicare will be secondary payer. If you choose Medicare to be your primary plan, coverage under this Plan will end. If you do not specifically choose one of the options, this Plan will continue to be primary.

If you choose the Capron Company, Inc. Health Care Plan as your primary payer, this Plan will pay the same benefits as if you or your spouse were under age 65. If you have enrolled in Medicare, you may then also send any unpaid portion of your bills to Medicare.

Please contact the Human Resources Department for further details in making this important decision.

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TERMINATION OF BENEFITS

Coverage under this Plan will terminate on the earliest of the following dates:

1. The date of the termination of the Plan, or the date the Plan ceases for the class of employees to which you belong, the date the employer terminates its participation in the Plan;

2. The last day in which an employee ceases to be an employee regularly scheduled to work full-time;

3. The date of entry to the military service of any country or international organization on a full-time active duty basis other than scheduled drill or other training not exceeding one month in any calendar year; and

4. The last day of an approved leave of absence under the Family and Medical Leave Act, if the employee does not return to work.

Dependent's coverage will terminate the last day of the month in which the dependent ceases to meet the definition of a dependent as defined in the Plan, or on the date an employee's coverage is terminated, or on the date of failure to make any required contributions as a regularly scheduled full-time employee or under an approved leave of absence under the Family and Medical Leave Act.

Certificates of Coverage will be issued within the time periods specified in federal regulations following loss of coverage in compliance with the provisions of the Health Insurance Portability and Accountability Act of 1996.

NOTE: It is the employee's responsibility to notify the Human Resources Department in writing within 60 days when an employee or a dependent has a qualifying event occur and that employee or dependent is no longer eligible for benefits. FAILURE TO NOTIFY THE HUMAN RESOURCES DEPARTMENT WILL RESULT IN COVERAGE BEING TERMINATED AS OF THE ORIGINAL DATE OF THE OCCURRENCE. ANY CLAIMS PAID AFTER THAT DATE MUST BE REIMBURSED TO THE EMPLOYER.

TERMINATION DUE TO DISABILITY

Eligibility for coverage will terminate after 90 days during which the employee did not perform all of his/her own duties on a full-time basis due to disability.

TERMINATION DUE TO LAYOFF/REDUCTION IN HOURS

If a covered person becomes ineligible for coverage due to layoff or reduction in hours, he may reapply for coverage provided he returns to work or increases his hours within 90 days, completes the required waiting period and applies for coverage within 31 days after his return to work or increase in hours.

No pre-existing limitations will apply.

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FAMILY AND MEDICAL LEAVE ACT

The Family and Medical Leave Act (FMLA) provides leaves of absence up to 12 weeks for the birth or adoption of a child, care of an immediate family member with a serious health condition, or because of the employee’s inability to perform the functions of his or her job due to the employee’s own serious health condition. Health coverage benefits during your approved leave of absence under The Family and Medical Leave Act will continue as long as you pay any required contributions. If you do not return to work at the end of an approved leave, you will be required to reimburse the employer the difference between any required contributions and the total monthly premium.

It is the employee’s responsibility to request leave under the FMLA and to comply with all requests for information, such as medical certifications, made by your employer. When the need for leave is foreseeable, the employee must provide reasonable prior notice and make efforts to schedule leave so as not to disrupt company operations. If you have any questions concerning your rights under the Family and Medical Leave Act, or your employer's responsibilities under the Act, please contact the Human Resource Department.

Service Member Family Leave: An eligible employee who is the spouse, son, daughter, parent, or next of kin of a service member who is recovering from a serious illness or injury sustained in the line of duty on active duty is entitled to 26 weeks of leave in a single 12-month period to care for the service member. This leave is available during a “single 12-month period” during which an eligible employee is entitled to a combined total of 26 weeks of all types of FMLA Leave combined.

MILITARY LEAVE ACT

Uniformed Services Employment and Reemployment Rights Act of 1994 (“USERRA”)

In the event an employee, who is a member of the United States Armed Forces Reserves, is called to active duty he may elect to continue Plan coverage for up to 24 months, beginning on the date the employee’s absence starts. The employee may be required to pay up to 102% of the full premium cost for continuation coverage, except a person on active duty for 30 days or less will not be required to pay more than the employee’s share, if any, for the coverage. These rights apply only to employees and their dependents covered under the Plan before leaving for military service. If you have any questions regarding military leave of absence, continuation of coverage, the cost of continued coverage or the maximum period of such coverage, please contact the Human Resources Department.

If your participation in this Plan is terminated by reason of service in the uniformed ser -vices, your coverage will be reinstated upon re-employment without any exclusions or waiting periods that would not have applied if coverage had not been terminated. How-ever, applicable exclusions may be imposed with respect to coverage of any illness or injury determined by the Secretary of Veterans Affairs to have been incurred or aggra-vated during service in the military.

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CLAIM FORM PROCEDURE

A claim form must be submitted each calendar year for a Covered Person. It is the employee’s responsibility to file the annual claim form with The Loomis Company. Claims processing will be withheld pending The Loomis Company’s receipt of the required claim form. Additional claim forms will only be required as needed by The Loomis Company.

PPO CLAIMS PROCEDURE

When you utilize the services of PPO hospitals, physicians and other providers, your involvement in the claims process will be minimal. After you identify yourself as covered through the Capron Company, Inc. Health Care Plan, bills incurred for covered expenses under this Plan will be sent directly to the PPO identified on your heath plan ID card.

When the hospital or other provider sends their bills to the PPO, the payment will be sent to the providers directly. You will receive a copy of the Explanation of Benefits form showing the payments made and any deductibles or co-insurance involved in the benefits calculation.

All claims must be filed within twelve (12) months of the date that the service has been delivered, unless there are reasonable circumstances that would prevent you from doing so.

PLEASE BE SURE THE PPO PROVIDER HAS CURRENT BILLING INSTRUCTIONS PROVIDED ON YOUR IDENTIFICATION CARD. FAILURE TO SUBMIT CLAIMS PROPERLY WILL RESULT IN DELAYED CLAIMS PROCESSING.

NON-NETWORK CLAIMS PROCEDURE

When you or a covered dependent have incurred medical expenses for which you believe reimbursement is due under the terms of our Plan, you must file the necessary documentation with the Benefit Services Manager, The Loomis Company, P.O. Box 7011, Wyomissing, Pennsylvania 19610-6011. There is a non-network claim form that notifies our claims office in Pennsylvania that the attached claim is a non-network claim and should be processed without delay. Use of this form will reduce the amount of time it takes to process a non-network claim. Otherwise the claim follows the same procedure as an in-network claim and will have to be sent to the PPO for repricing and verification that they are not participants in the network. This delays the processing and payment of your claim. Please see your Human Resources Director for copies of the Non-Network Claim Form.

It is your responsibility to file all claims within twelve (12) months of the date that the service has been delivered unless there are reasonable circumstances that would prevent you from doing so. It is your responsibility to provide any information that is necessary for The Loomis Company to make a prompt and fair evaluation of your claim. It is suggested that each time you file a claim the following information is provided:

1. Identify yourself and your employer by using your Social Security Number and the Plan Number as shown on your Identification Card. If the claim is for a dependent, identify that individual in the same fashion as you did on your enrollment form.

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2. Have all charges presented on an original itemized bill listing dates of service, type of service and the charge for each service as rendered, including the provider's name, address, telephone number, and tax identification number.

3. Either on the claim form or the bill have the attending physician identify the diagnosis for which treatment was rendered.

NON-NETWORK SERVICES WILL BE PAYABLE AT THE PPO RATE UNDER THE FOLLOWING CIRCUMSTANCES:

1. Individuals residing outside a PPO Service area (See the Human Resources Department to determine PPO service area).

2. Services to eligible dependents residing outside the employee’s PPO geographic service area.

3. Services not available within the PPO system.

4. Services rendered by a Non-Network provider when referred by a PPO provider. (You may be required to provide evidence that the Non-Network referral is medically necessary and/or appropriate treatment is not available from a PPO provider. The claim may be processed at the Non-Network rate until the documentation has been received by the Benefit Services Manager)

5. Services rendered by a Non-Network provider at a PPO facility.

6. Medical emergency.

NOTE: You may be billed for any amounts in excess of the reasonable and customary charge for services rendered by a Non-Network provider.

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CLAIMS APPEAL PROCESS

If you want to appeal a claim denial, you must submit a written request to Capron Company, Inc. within 90 days after you receive the denial notice. Your request should include appropriate issues, comments, and reasons why you think your claim should not have been denied. You also have the right to view the documentation that was used to decide your claim (such as the legal plan document and other plan materials and/or contracts).

When your request is received, the claim will then be reconsidered and given a fair and full review. Normally, you will receive written notice of the decision within 60 days unless special circumstances require an extension for processing. In that case, the decision will be made no later than 120 days after your request was received. When a decision is reached, you will receive a second notice that will include the reason for the decision, with references to any pertinent provisions.

In reviewing claims, Capron Company, Inc. has the authority to interpret Plan provisions and resolve factual issues. Capron Company, Inc. decisions will be final and binding. The procedure outlined above applies to you, your dependents, or any other person who has a right to benefits under the Plan.

Right to Receive and Release Needed Information Certain facts are needed to apply the rules of this provision. Capron Company, Inc. has the right to decide which facts are required and may obtain the needed facts from or provide them to any other organization or persons. Capron Company, Inc. need not disclose, or obtain the consent of any person to do this. Each person claiming benefits under this Plan must provide Capron Company, Inc. any information required to pay the claim.

You or your representative has 180 days after receipt of an adverse benefit determination to appeal to the Plan Administrator. To appeal an adverse benefit determination or to review administrative documents pertinent to the claim, send a written request to The Loomis Company. If any appeal is not filed on time, the right to appeal the adverse benefit determination will be lost. A full and fair review of the claim will be made with no deference given to the initial benefit determination. As part of the review, you or your representative are allowed to review all Plan Documents and other information that affect the claim and are allowed to submit issues, comments, documents, records or other information that had not previously been submitted.

During the period that the claim is being reconsidered, if there is reason to believe that your medical records contain information that should be disclosed by a physician or other health professional, you or your representative will be referred to the physician for the information before the Plan will provide the requested documents directly to you or your representative. Neither you nor your representative will be provided access to or copies of files of other Plan participants. For any appeal resulting in an adverse benefit determination, the identity of any medical or vocational expert consulted in connection with the appeal will be provided, without regard to whether the advice was relied upon in making the determination. However, the identity will not be provided unless re-quested by you or your representative.

All interpretations, determinations, and decisions of the reviewing entity with respect to any claim will be its sole decision based upon the Plan documents. All decisions of the

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Plan Administrator will be deemed final and binding. If appeal is denied, in whole or in part, however, you have a right to bring a civil action under Section 502(a) of ERISA.

Adverse Benefit Determination Any denial, reduction or termination of a benefit, or failure to provide or make payment (in whole or in part) for a benefit. An adverse benefit determination includes denials made on the basis of eligibility, utilization review, and restrictions involving services determined to be experimental or investigational, or not medically necessary or appropriate.

Compliance with RegulationsIt is intended that the claims procedures be administered in accordance with the claims procedure regulations of the Department of Labor as set forth in 29 CFR § 2560.503-1. You have a right to these procedures free of charge. Please call The Loomis Company if you wish to obtain a copy of these procedures.

Authorized RepresentativeA person who is chosen by and identified to assist or authorized to represent the Covered Person, including a family member, provider, employer representative or attorney. An assignment of benefits by a Covered Person to a health care provider does not constitute designation of an authorized representative.

Other Important Claims Information If you or your representative fail to file a request for review in accordance with the claims procedures as described above, you or your representative will have no right to review and you or your representative will have no right to bring an action in any court. The denial of your claim will become final and binding except as otherwise provided by ERISA.

Right to Receive and Release Needed Information Certain facts are needed to adjudicate claims in accordance with the provisions set forth in the Plan. The Plan Administrator has the right to decide which facts are required and may obtain the needed facts from or provide them to any other organization or persons. Each person claiming benefits under this Plan must provide any information required to pay the claim.

Medical PrivacyMedical information that is obtained and maintained in the course of processing claims will be secured and protected in accordance with state and federal laws regarding participant privacy rights.

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PRE-EXISTING CONDITIONS LIMITATIONS

The Plan will not compensate any Covered Person for expenses incurred for any condition, regardless of the condition, for which medical advice, diagnosis, care or treatment was recommended or received within the six month period prior to the enrollment date.* This limitation will not apply:

To expenses incurred after the end of the twelve-month period, including any waiting period, beginning on the enrollment date with respect to the Covered Person (this twelve-month period may be reduced by any period of prior creditable coverage).

The Health Insurance Portability and Accountability Act of 1996 also provides the following exceptions to allowable pre-existing condition limitations:

Pre-existing condition exclusions may not apply to members under the age of 19. Pregnancy may not be considered a pre-existing condition.

*Enrollment date is the first day of coverage, or the first day of waiting period if there is a waiting period.

Portability of Coverage A person (you or your dependent) will receive credit toward satisfaction of the Pre-Existing Condition Limitations described in this section for the time he/she was covered under another health plan, but only if:

1. Your service begins after the effective date of this Plan; and2. The person was covered, under another health plan that meets the definition of

“Creditable Coverage”, within the 62-day period just before his or her enrollment date under this Plan.

Any eligibility waiting period that the person is required to satisfy under this Plan will not be taken into consideration in determining the 62-day period.If the person was covered for a period to time under Creditable Coverage that is:

1. Greater than or equal to the time periods referred to in the Pre-Existing Conditions Limitations described in this section, then the Pre-Existing Conditions Limitations periods will not apply to the person.

2. Less than the time periods referred to in the Pre-Existing Conditions Limitations described in this section, then the Pre-Existing Conditions Limitations periods will be reduced by the number of consecutive days that the person was covered under Creditable Coverage.

However, for a child who became covered under Creditable Coverage within 31 days of birth, the Pre-Existing Conditions Limitations periods will not apply regardless of how long the child was covered under Creditable Coverage.

“Creditable Coverage” is defined as coverage under a group health plan, COBRA continuation coverage, individual health insurance coverage, Medicare, Medicaid or other public health plans, CHAMPUS, a medical program of the Indian Health Service or a tribal organization or the Peace Corps, state health benefit risk pools and the Federal Employee Health Benefit Plan (FEHBP).

Significant Break in Coverage – A period of 63 days or more during which an Employee or Dependent is not covered by any creditable coverage. Waiting periods are not included in the calculation of the break in coverage period.

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It is your responsibility to provide information about Creditable Coverage in order for the Pre-Existing Conditions Limitations under this Plan to be reduced or waived.

Certificates of Creditable Coverage may be obtained free of charge, from a Covered Person’s group health plan or health insurance issues when coverage under a plan is lost, when a Covered Person becomes entitled to elect COBRA continuation coverage, or when COBRA continuation coverage ceases. The request may be made before a Covered Person loses coverage, or within 24 months after losing coverage.

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COVERED MEDICAL EXPENSESYour benefit plan is designed to reimburse you for covered medical expenses you incur for treatment necessary because of an illness or an accident. All expenses must be Usual, Customary and Reasonable (UCR) in order to be considered for benefit payment.

Usual, Customary and Reasonable (UCR) means the usual charge made by the physician, hospital or other medical professional providing the service or medical supplies. However, this is limited also in that the charge shall not be in excess of the normal charges for similar services or supplies within the local area in which your service is rendered. Generally, the local area is defined as a county or such additional area as is necessary to obtain a reasonable cross section of other medical professionals or institutions providing such services or supplies.

A program of Predetermination is available. When possible, it is recommended that the Covered Persons obtain from their medical professionals an indication of what services are to be rendered and the cost of those services prior to the actual treatments being performed. This information should then be forwarded to The Loomis Company for review. The Loomis Company will provide the Covered Person with a written statement in advance of the treatment, identifying how much of the expense can be reimbursed through the benefit schedule.

PLEASE REFER TO THE SCHEDULE OF BENEFITS FOR DETAIL TO DETERMINE BENEFITS AND BENEFIT PERCENTAGES. LISTED BELOW ARE THE ELIGIBLE MEDICAL EXPENSES WHICH THE PLAN WILL CONSIDER FOR YOUR BENEFIT:Facility Expenses

1. Room and Board Maximum:a. Private room accommodation – average semiprivate rate (unless medically

necessary);b. Ward or semiprivate accommodation – most common rate;c. Intensive care accommodation.

2. Charges for pre-admission testing (screening X-rays and lab tests) which is done before a pre-scheduled Inpatient hospital confinement.

3. Special hospital charges for Inpatient medical care or supplies received during any period Room and Board Charges are made. This does not include personal supplies or convenience items.

4. Charges by a hospital or ambulatory surgical center for medical care and supplies received on an Outpatient basis.

5. Facility fee for diagnostic x-ray and laboratory examinations.6. Services provided by a birthing center.

Surgical Expenses1. Professional service charges made by a physician for medical services including

surgery and the administration of anesthesia by a physician other than the operating surgeon.

2. The services of an assistant surgeon not to exceed 20% of the reasonable and customary charge of the primary surgeon.

3. In some cases, two or more surgical procedures may be performed during the same session through the same incision, natural body orifice or operative field. The amount eligible for consideration is the reasonable and customary charge for the largest amount billed for one procedure, plus 50% of the reasonable and

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customary charge for the next largest procedure, and 25% of the sum of reasonable and customary charges for all other procedures performed.

4. Sometimes two or more surgical procedures may be performed during the same session through different incisions, natural body orifices or operative fields. The amount eligible for consideration is the reasonable and customary charge for the largest amount billed for one procedure, plus 50% of the sum of the reasonable and customary charges billed for all other procedures performed.

Professional Services1. Professional fees from a physician, as well as facility charges for diagnostic X-ray

and laboratory services.2. Expenses for Inpatient visitations by a physician, limited to one visit per day per

physician, excluding the day of surgery.3. Physician consultation services during hospital confinement.4. Expenses for second opinion consultation when required by the Utilization Review

Manager or patient.5. Office services of a physician, including psychiatric service charges of a physician

or licensed psychologist which relate to treatment of mental/nervous conditions, alcohol and substance abuse, subject to maximums and limitations stated in the Schedule of Benefits and Medical Expense Benefit Provisions.

6. Charges for the following limited as stated in the Schedule of Benefits:a. Nursing services of an R.N., on her own behalf, in or out of a hospital, if such

services are prescribed by a physician,b. Nursing services of an L.P.N., L.V.N., or P.H.N. on her own behalf in a hospital,

if such services are prescribed by a physician,c. Physiotherapy services by a physiotherapist.

7. Charges for the services of a qualified licensed speech therapist ordered by a physician if such charges are made for speech therapy used for the purpose of correcting speech loss or damage and/or oral motor defect that resulted from:a. Surgery for correction of a congenital condition of the oral cavity, throat, or

nasal complex (other than frenectomy);b. An injury;c. Sickness that is other than a learning or mental disorder;d. Congenital defects and birth abnormalities in a child.

8. Charges for therapy services when used for the treatment of a Sickness or Injury to promote recovery of the Covered Person. To be covered, the therapy services must be rendered in accordance with a Physician’s written treatment plan. Therapy services to include radiation, chemotherapy, cardiac rehabilitation, dialysis, physical, respiratory, electric shock and occupational therapy. (Occupational therapy may be used to correct non-occupational injuries received or to correct past surgical function or organic brain dysfunction. Learning disabilities, et. al. are not covered by this benefit).

Miscellaneous Service and Supply Expenses1. Benefits are provided for treatment in a Skilled Nursing Facility limited to 90 days for

any one illness or injury if:a. The Covered Person's condition requires skilled nursing care for continued

treatment; and;

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b. The Covered Person is admitted to the skilled nursing facility within five days following discharge from an accredited hospital wherein services were rendered for the same or related conditions causing the confinement in the skilled nursing facility.

2. Transportation charges as follows:a. Emergency ambulance transportation;b. Medically necessary professional ambulance for local transportation to and

from a hospital, but not more than 50 miles one way;c. Air ambulance service for a life-threatening emergency when travel exceeds 50

miles.3. Charges for the following services and supplies:

a. Man-made limbs or eyes for the replacing of natural limbs or eyes (initial replacement of natural limbs only);

b. Casts, splints, or crutches, orthotics, orthopedic or prosthetic devices (rental fees not to exceed purchase price), orthopedic or corrective shoes are not covered;

c. Oxygen and rental of equipment for giving oxygen; rental of wheelchair or hospital bed; rental of equipment to aid in breathing (purchase of durable medical equipment may be available when more cost effective than rental);

d. Dialysis equipment rental, supplies, upkeep and the training of the insured individual, or the one who attends him, to run the equipment;

e. X-ray, radium and radioactive isotopes therapy and blood transfusions;f. Charges for blood or blood plasma, x-ray therapy, radiation or chemotherapy

and treatment with radioactive substances, including materials and supplies of technicians.

g. Colostomy supplies, insulin, and other supplies used in the care and monitoring of diabetic patients;

h. Durable medical equipment – Rental or purchase (if more cost effective) of durable medical equipment when prescribed by a physician and required for the therapeutic use of the patient to treat an injury or illness.

4. Chiropractic services as stated in the Schedule of Benefits limited to $1,000 paid per Covered Person per calendar year for all medically necessary services. Chiropractic benefit payments do not accrue to the out-of-pocket maximum. Diagnostic services for Chiropractic Care do not accrue to the Chiropractic Care maximum.

5. The following coverage for a Covered Person who elects breast reconstruction in connection with a mastectomy who is currently receiving benefits with respect to the mastectomy:a. Reconstruction of the breast on which the mastectomy has been performed;b. Surgery and reconstruction of the other breast to produce symmetrical

appearance; andc. Coverage for prostheses and physical complications of all stages of

mastectomy, including lymphedemas, in a manner determined in consultation with the attending physician and the patient.

6. Allergy Testing and shots.7. First pair of contact lenses after cataract surgery.

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ORGAN TRANSPLANTS

1. The Plan provides benefits for organ transplants payable at 90% after satisfaction of the deductible for PPO providers. Organ transplants for non-Network providers are payable at 80% after satisfaction of the deductible.

Any replacement of tissue or organs, that is determined by the Office of Health Technology Assessment, Public Health Service, U.S. Department of Health & Human Services, to be non-investigational and non-experimental and is commonly and customarily recognized by the medical profession as appropriate treatment for a condition, will be covered by the Plan as any other illness.

2. Medical expenses of a donor in conjunction with a covered transplant are subject to benefit percentages and benefit maximums payable under the major medical provisions of the Plan as follows:a. Charges for obtaining donor organs are covered charges under the Plan when

the recipient is a Covered Person. When the donor has medical coverage, the donor's Plan will pay first. Benefits under this Plan will be reduced by those payable under the donor's plan.

b. Charges associated with the donation of organs or body tissues by a Covered Person are covered charges under the Plan when the donor is a Covered Person. When the recipient has medical coverage, the recipient's plan will pay first. Benefits under the Plan will be reduced by those payable under the recipient's plan.

c. Benefit payments for donor charges are included in the recipient's lifetime maximum when the recipient is a Covered Person.

d. The donor's expenses are limited to $10,000 lifetime maximum per Covered Person when the recipient is not a Covered Person.

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HOME HEALTH CARE EXPENSESThese are the charges made by a home health care agency, for the following services and supplies furnished to a family member in his/her home in accordance with a home health care plan. The home health care must have been established in lieu of hospital or skilled facility confinement.

1. Part-time or intermittent nursing care by a registered graduate nurse (R.N.) or by a licensed practical nurse (L.P.N.), if the services of a registered graduate nurse (R.N.) are not available.

2. Part-time or intermittent home health aide services which consist primarily of caring for the patient.

3. Physical therapy, occupational therapy, and speech therapy.4. Medical supplies, drugs and medicines prescribed by a physician, and laboratory

services provided by or on behalf of a hospital, but only to the extent that such charges would have been covered if the family member had remained in the hospital.

The maximum number of home health care visits to a family member's home that will be covered in any one calendar year is limited to 90. Each visit by a registered graduate nurse (R.N.) or licensed practical nurse (L.P.N.) to provide nursing care, by a therapist to provide physical, occupational, or speech therapy, and each visit of up to four hours of home health aide services shall be considered as one home health care visit.

Definition of Home Health Care AgencyAn agency or organization which meets fully every one of the following requirements:

1. It is primarily engaged in and licensed, if such licensing is required, by the appropri-ate licensing authority to provide skilled nursing services and other therapeutic services.

2. It has policies established by a professional group associated with the agency or organization – This professional group must include at least one physician and at least one registered graduate nurse (R.N.) to govern the services provided and such services must be under the full-time supervision of a physician or registered graduate nurse (R.N.).

3. It maintains a complete medical record on each patient.4. It has a full-time administrator.

Definition of Home Health Care Treatment PlanA program for continued care and treatment of a family member established and approved in writing by the attending physician within seven days following termination of a hospital confinement as a resident Inpatient and is for the same or related condition for which the family member was hospitalized. The physician must certify that the proper treatment of the disease or injury would require continued confinement as a resident Inpatient of a hospital in the absence of the services and supplies provided as part of the home health care plan.

LimitationsHome Health Care Expenses will not be included as Covered Medical Expenses if they are:

1. For services or supplies not specified in the home health care plan;2. For services of a member of your family, your spouse's family, or your household;3. For the services of any social worker;4. For transportation services.

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HOSPICE CARE BENEFITS

If a hospice care plan is set up for a Covered Person, the Plan will pay the "covered expense" (as defined in the Health Care Plan) but benefits or treatment, as the case may be, for any one hospice program per Covered Person per lifetime.

The term "Hospice" as used in this benefit provision means an agency that provides counseling and medical services to a terminally ill person. It may also provide room and board to such a person. A hospice must meet all of the following tests:

1. It has obtained any required state or governmental Certificate of Need approval.2. It provides service for 24 hours a day and 7 days a week.3. It is under the direct supervision of a physician.4. It has a nurse coordinator who is a graduate registered nurse.5. It has a licensed social service coordinator.6. The provision of hospice services is its primary purpose.7. It has a full-time administrator.8. It maintains written records of services provided to the patient.9. It is licensed, if licensing is required.

Any terms defined in the rest of the Plan shall have the same meanings when used herein.

If a physician certifies that a Covered Person in the Capron Company, Inc. Health Care Plan is terminally ill and expected to die within six months, this Plan will pay the covered expenses incurred for such a person. Such payment is subject to the following conditions and limited to the Hospice Care maximum:

1. Hospice care shall consist of the following services and supplies furnished directly by a hospice:a. Inpatient Care – The daily charge for such care may not exceed the semi-

private room rate of the hospital or nursing home with which the hospice is associated.

b. Outpatient care shall consist of:1) Part-time nursing care by or under the supervision of a graduate registered

nurse;2) Home health aide service;3) Nutrition service, including special meals;4) Counseling services by a licensed social worker or a licensed pastoral

counselor.

This Plan will also pay the covered expense incurred for counseling services for the immediate family of the covered terminally ill person. Payment is subject to the following conditions and limited to the Hospice Care maximums:

1. The counseling must be provided by a licensed social worker or a licensed pastoral counselor;

2. Bereavement counseling must take place during the six-month period following the Covered Person's death; and

3. "Immediate family" includes only the covered employee, spouse and their children.

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LimitationsThis benefit is limited by all the limitations as listed in this section, as well as all limitations of the Plan as a whole. Outpatient counseling limitations under mental and nervous conditions are separate from this provision.

Payment under this Hospice Care Benefit Provision shall in no way preclude payment of benefits under other provisions of the Plan.

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MATERNITY BENEFITS

Maternity benefits are available to covered female employees of the employer and/or covered dependent spouses of male employees. Maternity benefits are not available to dependent children.

A. Physician and Hospital – If a covered person is treated by a physician or confined as a registered bed patient in a hospital as a result of a pregnancy, the Plan will pay the amount charged by the physician for his services and the amount charged by the hospital for bed and board and for necessary services and supplies in the same manner as expenses related to any other disability under this Plan.

As part of the mother's hospital expense benefits under the Plan, payment will be made for the following charges for the child:

1. Hospital nursery charges and services and supplies for the newborn.2. Hospital routine X-Rays and examination for the newborn.3. Hospital charges related to circumcision for the newborn.4. Doctor's charges related to circumcision and the child's initial checkup.

B. Birthing Center Benefits – This Plan covers charges made by a birthing center on its own behalf for services and supplies furnished to a covered person in connection with a pregnancy covered by the Plan. Eligible charges include: (1) Prenatal care, (2) Delivery and post-delivery care rendered within 72 hours after the delivery, and (3) Services by a certified nurse midwife.

C. Sterilization – Medical charges in connection with elective sterilization are considered eligible under this Plan.

D. Infertility Benefits – This Plan covers charges for expenses in relation to diagnostic testing to determine the cause of infertility. Treatment of infertility is covered up to the limits shown in the Schedule of Benefits. Prescriptions for treatment of infertility will be covered under the medical plan subject to the infertility maximum benefit (combined for husband and wife) in the schedule of benefits.

TERMINATION OF PREGNANCY

Medical charges in connection with the elective termination of a pregnancy are not considered eligible under this Plan. An abortion considered to be therapeutic and medically necessary for the mother's health or in the case of rape or incest is covered as an eligible expense.

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PREVENTIVE CARE BENEFITThe Plan covers the following preventive services subject to a $10 co-payment for the office visit and then 100% of the Allowable Expense for network providers or 80% of the UCR charge (after the deductible is met) for non-network providers.

1. Well Baby Care – Well child care, including immunizations, diagnostic testing, inoculations and boosters as recommended by the American Academy of Pediatrics. Maximum benefit of $300 per Covered Person per calendar year.

2. Routine Adult Physicals – Charges for routine physical exams, diagnostic testing and immunizations. Maximum Benefit of $300 per Covered Person per Calendar year. These benefits also include: Routine Mammogram – All covered females. No co-pay applies to this benefit.

a) A baseline mammogram for a woman from age 35 through 39; orb) A mammogram for a woman from ages 40 through 49, every two years or

more frequently based on the recommendation of the woman’s physician; orc) A mammogram every year for a woman 50 years of age and over.

Routine GYN Exam/Pap Smear – One exam and pap smear per calendar year for all covered females.

Routine Prostate Exams. One time Shingles vaccination for members age 65 or older (does not accrue to

the Preventive Care Maximum Benefit).

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PRESCRIPTION DRUG EXPENSE BENEFITThe Capron Company, Inc. Health Care Plan provides a Prescription Drug Plan. The Plan requires that the Covered Person pay $5 per covered generic prescription, $10 per covered preferred name brand prescription, and $20 per covered non-preferred name brand prescription. The cardholder is responsible for the applicable co-payment when the card is presented in the drug store.

Qualifying expenses include: Oral contraceptives VIAGRA (dispensed up to a maximum of 6 tablets per month). Diabetic supplies. Injectables that are medically necessary and pre-authorize. Prescription drugs necessary for the care and treatment of an illness. Expenses incurred on the written prescription of a physician. Reasonable and Customary charges. Expenses not listed as excluded charges.

The maximum quantity of drugs considered to be a qualifying expense may not exceed a 34-day supply when taken in accordance with the directions of a physician, except for the following drugs dispensed in amounts of 100 units, even though when taken in accordance with the directions of a physician would exceed a 34 day supply.

(a) Nitroglycerine(b) Phenobarbital(c) Thyroid and synthetics(d) Digitalis and derivatives(e) Orinase(f) Diabinese(g) DBI, DBI-TD(h) Dymelor(i) Tolinase

The maximum quantity of ointments or creams considered to be a qualifying expense may not exceed four ounces per prescription.

No benefits will be paid for charges incurred for: Charges for non-legend drugs, other than injectable insulin or charges for the

administration or injection of any drug. Any prescription that you are entitled to receive without charge from any

Workers Compensation or similar law or municipal state or Federal program. Charges incurred for prescription drugs prior to the effective date of this Plan. Any prescription refilled in excess of the number specified by the physician or

any refill dispensed after one year from the physician's original order. Drug labeled "Caution-Limited by Federal Law to Investigational Use" or

experimental drugs, even though a charge is made to the individual. Charges for medication that is to be taken by or administered to you, in whole

or part, while you are a patient in a licensed hospital, rest home, sanitarium, extended care facility, convalescent hospital or nursing home.

Charges for drugs relating to the treatment of infertility. Drugs for tobacco dependency. Cosmetic drugs, even if ordered for non-cosmetic purposes. Charges for giving or injecting drugs.

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Growth hormones (except when proven by the pre-certification vendor that growth hormones are needed for a pituitary deficiency disorder or pituitary cancer).

Immunization agents, biological sera, blood and plasma. Therapeutic devices or appliances, including colostomy supplies, support

garments, needles and syringes, regardless of intended use. (This exclusion does not apply to disposable insulin needles and syringes that are covered under the Plan.)

Injectables (exclusion does not apply to insulin or those injectables that are pre-authorized to be medically necessary).

Progesterone compounded. Appetite suppressants or vitamins. Aphrodisiacs.

MAIL ORDER

A Mail Order Pharmacy option is included. If you use a Mail Order Pharmacy you must pay a $4 co-payment per mail order prescription (includes generic and name brand prescriptions). The amount supplied will be limited to the amount in a single prescription up to a maximum of 90 days. Prescriptions are normally written for a 30 day supply. If you wish to have a 90 day supply, your Doctor will need to write a prescription for a 90 day supply.

Contact Express Scripts at the phone number listed on your identification card for an explanation of how to submit a prescription to the Mail Order Pharmacy. The same covered expenses and limitations apply to the Mail Order Pharmacy benefits.

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MEDICAL EXCLUSIONS AND LIMITATIONSNo payment will be made under any provision of this Plan for expenses incurred by a Covered Person for:

1. Services, treatment or supplies including any period of hospital confinement, unless such services and treatment were prescribed as necessary by a physician for the treatment of an illness or injury.

2. Expenses in connection with bodily injuries arising from or in the course of any employment.

3. Expenses in connection with illnesses for which benefits are provided under any workers' compensation act or similar law.

4. Charges for which the Covered Person and/or the Plan are not legally required to pay, including charges which would not have been made if no coverage existed.

5. Charges by a facility owned or operated by the United States or any state or local government unless the Covered Person is legally obligated to pay.

6. Charges which are determined not to be medically necessary.

7. Charges for services and/or supplies provided before the effective date of coverage under the Plan, or provided after termination of coverage under the Plan.

8. Routine physical examinations, including premarital exams, and immunizations and inoculations, except as specifically provided for in the Schedule of Benefits.

9. Eye refractions, eye glasses, contact lenses, the fitting of eyeglasses. (First pair of eyeglasses or contact lenses after cataract surgery is covered.)

10. Hearing aids or the fitting of hearing aids.

11. Cosmetic or reconstructive procedures, and any related service or supplies, which alter appearance but do not restore or improve impaired physical function, except as specifically provided, or when performed for the:a. Repair, within one year of the accident, of defects resulting from an accident;b. Replacement of diseased tissue surgically removed; orc. Treatment of a birth defect in a child.

12. Operation or treatment of the teeth or the supporting tissues of the teeth except a. Tumors b. Treatment of accidental injury to sound natural teeth (including their

replacement) due to an accident c. Extraction of teeth not through the gum d. Hospital charges for extraction of teeth or other dental processes provided

hospitalization is certified by a licensed physician or a doctor of dental surgery as being necessary to safeguard the health of the person confined.

13. Operation or treatment in connection with the fitting or wearing of dentures.

14. Treatment of injury or illness which is occasioned by insurrection or war (declared or undeclared).

15. Charges incurred outside the United States or Canada, unless the Covered Person is a resident of the United States or Canada and the charges are incurred while traveling on business or for pleasure.

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16. Custodial care.

17. Charges for experimental drugs, medicines, treatments, procedures and therapies. A drug or medicine will be considered experimental unless, at the time it is provided, it is commercially available and approved for general use by the United States Food and Drug Administration as effective for treatment or diagnosis of the condition for which the charge is made. The approval must not be on a limited or an experimental basis. A treatment, procedure or therapy will be considered experimental unless at the time it is provided or performed, it is considered effective for the treatment or diagnosis of the condition for which the charge is made. The treatment, procedure or therapy must not be considered effective on a limited or an experimental basis.

18. Charges due to tissue transplants, organ transplants or replacement of tissue or organs, whether natural or artificial materials or devices are used, and all charges due to complications arising from such procedures or treatment are excluded from coverage, except as provided in the Organ Transplants section of this Summary Plan Description.

19. Blood or plasma to the extent a refund or credit is made as a result of operation of a group blood bank, replaced by or for the patient, or otherwise.

20. Exercise for the eyes.

21. Treatment for expenses incurred specific to obesity due to overeating, weight reduction, dietary or weight control.

22. Abortion, unless the life of the mother would be endangered if the fetus was carried to term, or the pregnancy is the result of rape or incest.

Benefits are payable for expenses incurred for treatment of medical complications arising from an abortion.

23. Radial keratotomy, or other eye surgery to correct near-sightedness.

24. Education and training.

25. Personal care or comfort items during hospitalization, such as, but not limited to, barber/beautician services, radio, television, and telephone services, guest meals, guest cots, rental of humidifiers, massage equipment, air conditioners.

26. Charges for treatment or services of physicians, nurses, chiropractors, physiotherapists, or other practitioners, who live in your home and/or if the provider of service is the employee, employee’s spouse, child, brother, sister or parent.

27. Equipment or supplies made or used for physical fitness, athletic training, or general health upkeep.

28. Care and treatment for hair loss, including wigs, hair transplants, or any drug that promises hair growth, whether or not prescribed by a physician.

29. Care and treatment for smoking cessation programs, including, but not limited to, smoking deterrent patches and smoking deterrent gums.

30. Expenses for routine foot care, such as corns, calluses, flat foot conditions, supportive devices for the foot, treatment of subluxations of the foot (except

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capsular or bone surgery), toe nails (except surgery for ingrown nails), fallen arches, weak feet, chronic foot strain, and symptomatic complaints of the feet.

31. Charges for services rendered for the following treatments except as otherwise stated in Covered Medical Expenses:a. Voluntary sterilizationb. Reversal of sterilization c. Sex changed. Biofeedbacke. Sexual dysfunction or inadequaciesf. Artificial inseminationg. Invitro fertilizationh. Embryo transfer proceduresi. Infertility, except as related to an underlying diagnosed medical conditionj. Routine genetic counseling or testing unless medically necessary.

32. Expenses incurred for any intentionally self-inflicted injury or illness while sane or insane, or injury or illness resulting from taking part in the commission of an assault or felony.

33. Expenses incurred while committing or attempting to commit suicide, while sane or insane.

34. Expenses incurred relative to special therapies such as infant stimulation and patterning therapy (except for newborn children), music therapy, travel or rest cures, and hospital charges for patient's relatives or guests.

35. Ambulance service where no medical necessity or medical emergency exists.

36. Treatment or any method used to alter vertical dimension by any method of any joint or articulation problems of the jaw or conditions manifested by the jaw, including pain, or its articulation or any method used to alter vertical dimension including Temporomandibular Joint Syndrome and craniomandibular disorders, or other conditions of the joint linking the jaw bone and skull which linking is to include the complex of muscles, nerves, and other tissues of that joint.

37. Treatment for the correction of malocclusion, protrusion or recession of the mandible, maxillary or mandible hyperplasia, or maxillary or mandible hypoplasia.

38. Expenses incurred for Acupuncture, except as specifically provided for in the Schedule of Benefits.

39. Expenses incurred for Hypnosis.

40. Expenses for vision therapy, except when documentation for medical necessity is received from a Pediatric Ophthalmologist and approved by the Utilization Review Manager.

41. Orthopedic or corrective shoes.

42. Used to satisfy the deductibles.

43. For marital counseling, family counseling or sex counseling.

44. For nursing, medical or surgical care or treatment rendered by a spouse, child, brother, sister, parent, or parent of a spouse.

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45. For cosmetic surgery and complications resulting from cosmetic surgery, except for treatment of an injury or a birth defect of a child.

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DENTAL PLAN BENEFITSIf a covered person incurs expenses for dental care that are medically necessary and recommended by a physician or dentist, the Plan will pay the usual, customary and reasonable amount shown in the Schedule of Benefits.

The Plan will pay for covered charges incurred by a covered person while he or she is insured by this Plan. All covered charges are considered to be incurred on the date the services are furnished.

LEVEL 1 – PREVENTIVE DENTAL SERVICESA. Prophylaxis and Fluoride Treatments – Prophylaxis (limited to two treatments

per calendar year) – allowance includes examination, scaling and polishing.

Topical application of fluoride (limited to covered persons under age 18 and limited to 2 treatments per calendar year) – allowance includes examination and prophylaxis.

B. Space Maintainers – (limited to covered persons under age 16 and limited to initial appliance only) – allowance includes all adjustments in the first six months after installation.

Fixed, unilateral, band or stainless steel crown typeFixed, unilateral, cast typeRemovable, bilateral type

C. Fixed and Removable Appliances to inhibit thumb sucking and other harmful habits (limited to covered persons under age 16 and limited to initial appliance only) - allowance includes all adjustments in the first six months after installation.

D. Diagnostic Services – Allowance includes examination and diagnosis.X-Rays- Full mouth series of at least 14 films including bitewings, if needed (limited

to once in any 36 consecutive month period)- Bitewing films (limited to a maximum of four films in any six consecutive

month period)- Other intraoral periapical or occlusal films – Single film- Extraoral superior or inferior maxillary film- Panoramic film, maxilla and mandible (limited to once in any 36

consecutive month period)E. Office Visits and Examinations

- Initial or periodic oral examination (limited to two examinations per calendar year)

- Emergency palliative treatment and other non-routine, unscheduled visitsF. Sealants – Limited to two treatments per calendar year.

LEVEL 2 – BASIC DENTAL SERVICESA. Office Visits and Examinations – Diagnostic consultation, providing it is:

1. With a dentist other than the one providing treatment, and2. Not with a dentist specializing in prosthodontics or orthodontics.(Limited to one consultation for each dental specialty in any 12 consecutive month period.)

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B. Diagnostic Services – Allowance includes examination and diagnosis including:- Diagnostic casts and- Biopsy and examination of oral tissue

C. Restorative Services – Multiple restorations on one surface will be considered one restoration.- Amalgam restorations- Synthetic restorations

Silicate cementAcrylic or plasticComposite resin

- PinsPin retention, exclusive of restorative material

- RecementationInlay or onlayCrownBridge

D. Endodontic Services – Allowance includes routine X-Rays and cultures, but excludes final restoration.- Pulp capping, direct- Remineralization (Calcium Hydroxide), as a separate procedure- Vital pulpotomy- Apexification- Root canal therapy of non-vital (nerve-dead) teeth

Traditional therapyMedicated paste therapy, N2 Sargenti

- Apicoectomy, as a separate procedure or in conjunction with other endodontic procedures

E. Periodontic Services – Allowance includes the treatment plan, local anesthetics and post-surgical care.- Gingivectomy or gingivoplasty, per quadrant- Gingivectomy, per tooth (fewer than 6 teeth)- Sub-gingival curettage and root planning, per quadrant (limited to a

maximum of four quadrants in any 12 consecutive month period)- Pedicle or free soft tissue grafts, including donor sites- Osseous surgery, including flap entry and closure, per quadrant- Osseous grafts, including flap entry, closure and donor sites- Muco-gingival surgery- Occlusal adjustment not involving restorations and done in conjunction

with periodontic surgery, per quadrant (limited to a maximum of four quadrants in any 12 consecutive month period)

F. Oral Surgery – Allowance includes routine X-Rays, the treatment plan, local anesthetics and post-surgical care.Extractions:- Uncomplicated extraction, one or more teeth- Surgical removal of erupted teeth, involved tissue flap and bone removal- Surgical removal of impacted teeth- Excision of pericoronal gingiva, per tooth- Removal of palatal torus- Removal of cyst or tumor

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- Incision and drainage of abscess- Closure of oral fistula or maxillary sinus- Reimplantation of tooth- Frenectomy- Suture of soft tissue injury- Sialolithotomy for removal of salivary calculus- Closure of salivary fistula- Dilation of salivary duct- Sequestrectomy for osteomyelitis or bone abscess, superficial- Maxillary sinusotomy for removal of tooth fragment or foreign body

G. Other Services- General anesthesia in conjunction with surgical procedures only- Injectable antibiotics needed solely for treatment of a dental condition

LEVEL 3 – MAJOR RESTORATIVE & PROSTHODONTICS CAREA. Restorative

Gold Foil Restorationsgold foil - one surfacegold foil - two surfacesgold foil - three surfaces

Gold Inlay Restorationsinlay - gold, two surfacesinlay - gold, three surfacesonlay - per tooth (in addition to above)

Porcelain Restorationsinlay - porcelain

Crowns - Single Restorations Onlyplastic (acrylic)plastic (prefabricated)plastic with goldplastic with nonprecious metalporcelainporcelain with goldporcelain with nonprecious metalgold (full cast)nonprecious metal (full cast)gold (3/4 cast)stainless steelcast post and core in addition to crown

B. Other Restorative ServicesCrown buildups – Pin retained

C. Prosthodontics, RemovableD. Complete Dentures – Including six months post-delivery care

Complete upperComplete lowerImmediate upperImmediate lower

E. Partial Dentures – Including six months post-delivery careUpper – Without clasps, acrylic base

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Lower – Without clasps, acrylic baseUpper – With two gold clasps with rests, acrylic baseLower – With two gold clasps with rests, acrylic baseLower – With gold lingual bar and two clasps, acrylic baseLower – With gold lingual bar and two clasps, cast baseUpper – With gold palatal bar and two gold clasps, cast baseRemovable unilateral partial denture 1 piece gold casting, clasp attachments, per

unit including ponticsFull cast partial – With two gold clasps (upper)Full cast partial – With two gold clasps (lower)

F. Additional units for Partial DenturesEach additional clasp with restEach tooth (applies only to full cast partial)

G. Prosthodontics, FixedH. Fixed Bridges (Each abutment and each pontic constitutes a unit in a bridge.)I. Bridge Pontic

Cast goldCast nonpreciousSlotted facingSlotted ponticPorcelain fused to goldPorcelain fused to nonprecious metalPlastic processed to goldPlastic processed to nonprecious metal

J. RetainersGold inlay – Two surfacesGold inlay – Three or more surfacesGold inlay (onlying cusps)

K. CrownsPlastic (acrylic)Plastic processed to goldPlastic processed to nonprecious metalPorcelainPorcelain fused to goldPorcelain fused to nonprecious metalGold (3/4 cast)Gold (full cast)Nonprecious metal (full cast)

L. Other Prosthetic ServicesDowel pin, metal

M. Tooth ImplantsLEVEL 4 – ORTHODONTIC TREATMENT “Orthodontic Treatment” means the movement of teeth by means of active appliances when required to correct either:1. Overbite or overjet of at least 4 millimeters;2. Maxillary and mandibular arches in either protrusive or retrusive relation of at least 1

cusp;

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3. Crossbite;4. Arch length discrepancy of more than 4 millimeters.

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LIMITATIONSNO PAYMENT UNDER THE PLAN WILL BE MADE FOR:1. Any procedure which began before the date the covered person became

covered under the employer's Plan.

2. Initial installation of bridgework or dentures replacing natural teeth extracted prior to becoming covered under this Dental Expense Benefit. This exclusion will cease at the end of the first 24 months of continuous coverage for a covered person.

3. Services performed by a dental hygienist if the treatment is not rendered under the supervision of a dentist.

4. Any dental procedure performed for cosmetic reasons unless needed for repair of damage resulting from an accident occurring while covered and the procedure is performed:(a) Within two years after the accident; (b) While the covered person's coverage is in force.

5. Any of the following services: (a) Dietary planning; (b) Oral plaque control instruction; (c) Training in preventive dental care.

6. Any procedure whose primary purpose is to alter vertical dimension or restore occlusion.

7. A temporary full prosthesis or any duplicate prosthetic device.

8. The replacement of any prosthesis within five years after it was first placed, except if: (a) A crown is needed for restorative purposes only; or (b) Replacement is needed because of initial placement of an opposing full prosthesis or the extraction of teeth; or (c) The prosthesis is a stayplate, or a similar temporary partial prosthesis; or (d) The prosthesis, while in the mouth, has been damaged beyond repair as a result of injury occurring while covered.

9. The replacement of a prosthesis which, in the dentist's opinion, can be re-made satisfactorily.

10. The replacement of a lost, missing or stolen dental prosthesis or dental device.

11. Charges for failure to keep a scheduled visit with a dentist or for the completion of any claim forms.

12. Any supplies or services (a) For which no charge is made, (b) For which you are not required to pay or (c) Furnished by or payable under any plan or law of any Government, Federal or State, Dominion or Provincial, or any political sub-division thereof.

13. Any expenses incurred for which the person on whom claim is presented has or had a right to compensation under any workers compensation or occupational disease law or for a condition which arises from or is sustained in the course of any occupation or employment for compensation, profit or gain.

14. Temporary crowns unless the cost of the temporary and permanent crown is equal to or less than the usual, customary and reasonable cost of a permanent crown.

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15. If coverage is elected more than 31 days after the date an individual becomes eligible. In addition, the total benefits payable for all Levels 1, 2, and 3 Dental Services performed with respect to such individual will not exceed $100 during the first 12 months that such individual is covered.

16. For any intentionally self-inflicted injury or illness. In compliance with the Health Insurance Portability and Accountability Act, if an injury (including self-inflicted injury) results from a dental condition or act of domestic violence, the Plan will not deny benefits for the injury.

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COORDINATION OF BENEFITS PROVISION

The purpose of this Plan is to provide you with reimbursement of your covered medical expenses based on the description of coverage as outlined in the Schedule of Benefits section of this booklet. In the event that you or any of your covered dependents incur expenses for which benefits are payable under this Plan and at the same time benefits are payable under any other plan, the Plan will coordinate benefits. In coordinating benefits, one of the two or more plans involved will be the primary plan, and the other plans will be secondary to it. If this Plan is the primary plan, it will pay as if there were no other plans involved. If this Plan is the secondary plan, it may make additional payment for covered expenses after any applicable deductible, but only to bring the cumulative total paid by both plans combined to the amount that this Plan would have paid if it were the only plan.

Examples of other types of coverage with which benefits will be coordinated are:

1. Insurance or any other arrangement of benefits for individuals of a group.

2. Pre-payment coverage, or any other coverage toward the costs of which any employer makes contributions or payroll deductions or any labor union makes contributions.

3. Any governmental program or coverage required by statute.

4. Coverage for students sponsored by or provided through a school or other educational institution.

5. The Medicare Program.

6. Automobile insurance which is subject to any Motor Vehicle Financial Responsibility Law. This Plan shall have secondary liability for those medical expenses incurred as a result of a motor vehicle accident, on behalf of a Covered Person subject to any state automobile insurance law, regardless of the terms and conditions of any specific automobile policy. Furthermore, if a Covered Person has no Personal Injury Protec-tion or medical benefits coverage, in a state where such coverage is mandated, coverage under this Plan shall be reduced by the minimum coverage requirement of the state with jurisdiction. In addition to the above, for those Covered Persons subject to the State of New Jersey no-fault automobile insurance law or the law of any other state which permits issuance of a state mandated motor vehicle policy with an optional high personal injury protection deductible, this Plan shall not recognize as a covered expense, the personal injury protection deductible selected by any Covered Person. Such deductible amount shall be the direct responsibility of the Covered Person.

The Plan will not consider as an allowable expense any charge that would have been covered by an HMO had a Covered Person for whom the HMO would be primary payor used the services of an HMO participating provider. The Plan will not consider any charge in excess of what an HMO provider has agreed to accept as payment in full.The rules establishing the order of benefit determination are as follows:

1. The benefits of a Plan that covers a person as the Employee (or other than a dependent) shall be considered primary and determined before the benefits of a Plan that covers such person as a dependent (the secondary plan);

2. When this plan and another plan cover the same child as a dependent of different parents (when the parents are neither separated nor divorced), the benefits of the plan covering the parent whose birthday falls earlier in a calendar year are determined

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before those of the plan covering the parent whose birthday falls later in the year. If both parents have the same birthday, the benefits of the plan that covered the parent for a longer period of time are determined first. This is known as the "Birthday Rule".However, if the "other" plan does not have the "Birthday Rule", but instead has a rule based on the gender of the parent, and if, as a result, the plans do not agree on the order of benefits, the rule of the other plan will determine the order of benefits. Exceptions include:

a. When the parents are separated or divorced and the parent with custody of the child has not remarried, the benefits of a plan which covers the child as a dependent of the parent with custody of the child will be determined before the benefits of a plan which covers the child as a dependent of the parent without custody;

b. When the parents are divorced and the parent with the custody of the child has remarried, the benefits of a plan which covers the child as a dependent of the parent with custody shall be determined before the benefits of a plan which covers that child as a dependent of the step-parent, and the benefits of a plan which covers that child as a dependent of the step-parent will be determined before the benefits of a plan which covers that child as a dependent of the parent without custody. If there is a court decree which would otherwise establish financial responsibility for the medical, dental, or other health care expenses with respect to the child, the benefits of a plan which covers the child as a dependent of the parent with such financial responsibility shall be determined before the benefits of any other plan which covers the child as a dependent child.

3. When Rules 1 and 2 do not establish an order of benefit determination, the benefits of a plan which has covered the person on whose expenses claim is based for the longer period of time shall be determined before the benefits of a plan which has covered such person the shorter period of time; provided that:

a. The benefits of a plan covering the person (on whose expenses the claim is based) as a retired employee or as the dependent of such person shall be determined after the benefits of any other plan covering such person as an employee other than as a retired employee or a dependent of such person.

b. If both parents of a covered dependent are covered as employees under this Plan, any eligible dependents may be covered as dependents of the parent whose birthday falls earlier in the calendar year, and there is no coordination of benefits within the same Plan.

Coordination with MedicareIndividuals may be eligible for Medicare Part A at no cost if they: (i) Are age 65 or older, (ii) Have been determined by the Social Security Administration to be disabled, or (iii) Have end stage renal disease. Participation in Medicare Part B and D is available to all individuals who make application and pay the full cost of the coverage.

1. When an employee becomes entitled to Medicare coverage (due to age or disability) and is still actively at work, the employee may continue health coverage under this Plan at the same level of benefits and contribution rate that applied before reaching Medicare entitlement.

2. When a dependent becomes entitled to Medicare coverage (due to age or disability) and the employee is still actively at work, the dependent may continue

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health coverage under this Plan at the same level of benefits and contribution rate that applied before reaching Medicare entitlement.

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3. If the employee and/or dependent is also enrolled in Medicare (due to age or disability), this Plan shall pay as the primary plan. If, however, the Medicare enrollment is due to end stage renal disease, the Plan's primary payment obligation will end at the end of the thirty (30) month "coordination period" as provided in Medicare law and regulations.

4. Notwithstanding Paragraphs 1 to 3 above, if the employer (including certain affiliated entities that are considered the same employer for this purpose) has fewer than one hundred (100) employees, when a covered dependent becomes entitled to Medicare coverage due to total disability, as determined by the Social Security Administration, and the employee is actively-at-work, Medicare will pay as the primary payer for claims of the dependent and this Plan will pay secondary.

5. If the employee and/or dependent elect to discontinue health coverage under this Plan and enroll under the Medicare program, no benefits will be paid under this Plan. Medicare will be the only payer.

This section is subject to the terms of the Medicare laws and regulations. Any changes in these related laws and regulations will apply to the provisions of this section.

Right to Receive or Release Necessary InformationTo make this provision work, this Plan may give or obtain needed information from another insurer or any other organization or person. This information may be given or obtained without the consent of or notice to any other person. A Covered Person will give this Plan the information it asks for about other plans and their payment of allowable charges.

Facility of PaymentThis Plan may repay other plans for benefits paid that the Plan Administrator determines it should have paid. That repayment will count as a valid payment under this Plan.

Right of RecoveryThis Plan may pay benefits that should be paid by another benefit plan. In this case this Plan may recover the amount paid from the other benefit plan or the Covered Person. That repayment will count as a valid payment under the other benefit plan.

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CONTINUATION OF COVERAGE

On April 7, 1986, a Federal law was enacted (Public Law 99-272, Title X) requiring that most employers sponsoring group health plans offer employees and their families the opportunity for a temporary extension of health coverage (called “continuation coverage”) at group rates in certain instances where coverage under the plan would otherwise end. This Notice is intended to inform you, in a summary fashion, of your rights and obligations under the continuation coverage provisions of the law. (Both you and your spouse, if you are married, are covered by the plan. Your spouse should take the time to read this Notice carefully.)

If you are an employee of Capron Company, Inc. and covered by the Capron Company, Inc. group health plan (called “the plan” in this Notice), you have the right to choose this continuation coverage if you lose your group health coverage because of a reduction in your hours of employment or the termination of your employment (for reasons other than gross misconduct on your part).

If you are the spouse of an employee and you are covered by the plan, you have the right to choose continuation coverage for yourself if you lose group health coverage under the plan for any of the following four reasons.

1. The death of the spouse;2. The termination of the spouse's employment (for reasons other than gross

misconduct) or reduction in the spouse's hours of employment;3. Divorce or legal separation from the spouse; or4. Your spouse becomes entitled to (that is, covered by) Medicare.

In the case of a dependent child of an employee covered by Klein Technologies, Inc. he or she may choose to continue coverage if group health coverage under the plan is lost for any of the following five reasons:

1. The death of the employee;2. The termination of the employee’s employment (for reasons other than

gross misconduct) or reduction in the employee’s hours of employment;3. The employee’s divorce or legal separation;4. The employee becomes entitled to (that is, covered by) Medicare; 5. The dependent ceases to be a "dependent child" under the Group Health

Care Plan.

Effective January 1, 1997, children born to, or placed for adoption with a covered employee during a continuation coverage period also have the right to elect COBRA continuation coverage.

The employee or the eligible family member has the responsibility to inform the Human Resources Department of a divorce, legal separation, or a child losing dependent status under the Plan within 60 days of the event. It is the responsibility of the Human Resources Department to notify the COBRA Administrator within 30 days of an employee's termination of employment, reduction in hours, *Medicare entitlement, or *death.

* If a second qualifying event is the death of the covered employee or the covered employee becoming entitled to Medicare benefits, a group health plan may require qualified beneficiaries to notify the Plan Administrator within 60 days of those events, as well. Ordinarily, the employer is responsible for notifying the Plan Administrator of an event

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that is the death of a covered employee or the covered employee becoming entitled to Medicare benefits. However, if the covered employee's employment has been terminated, the employer may not be in a position to be aware of those events. If the plan does not require qualified beneficiaries to notify the plan within 60 days of a second qualifying event that is the death of the covered employee or the covered employee becoming entitled to Medicare benefits, a qualified beneficiary should provide that notice by the later of the last day of the 18-month period or the date that is 60 days after the date of the second event.

Children born to, or placed for adoption with a covered employee during a continuation coverage period also have the right to elect COBRA continuation coverage. Enrollment must be completed and submitted in writing within 30 days of the event and any additional premiums (if applicable) paid prior to eligibility. Coverage will be retroactive to the date of the event.

You will be notified of your rights to continue coverage on a self-pay basis. You have at least sixty days from the date of the notice of your COBRA continuation of coverage rights to elect COBRA continuation coverage. If you do not choose continuation coverage, your group health insurance coverage will end as of the date you became ineligible to continue as a covered member of Capron Company, Inc. Health Care Plan.

If an employee becomes ineligible for employer paid health care coverage because of a reduction in hours scheduled or because of voluntary resignation, the employee’s continuation of coverage on a self-pay basis may last for up to 18 months. The 18 months may be extended to 29 months if a qualified beneficiary is determined to be disabled under Title II or XVI of the Social Security Act at any time within the first 60 days of continuation coverage. To benefit from this extension, you must notify the Plan Administrator of the disability determination within 60 days after the determination, and prior to the expiration of the initial 18-month COBRA period. The affected individual also must notify the Plan Administrator within 30 days of any final determination that the individual is no longer disabled.

18 to 36-Month Period (Second Qualifying Event): A spouse and dependent children who experience a second qualifying event may be entitled to a total of 36 months of COBRA coverage. Second qualifying events may include the death of the covered employee, divorce or legal separation from the covered employee, the covered employee becoming entitled to Medicare benefits (under Part A, Part B or both), or a dependent child ceasing to be eligible for coverage as a dependent under the group health plan. The following conditions must be met in order for a second event to extend a period of coverage:

(1) The initial qualifying event is the covered employee's termination of employment, or reduction of hours, which calls for an 18-month period of continuation coverage;

(2) The second event that gives rise to a 36-month maximum coverage period occurs during the initial 18-month period of continuation coverage (or within the 29-month period of coverage if a disability extension applies);

(3) The second event would have caused a qualified beneficiary to lose coverage under the plan in the absence of the initial qualifying event;

(4) The individual was a qualified beneficiary in connection with the first qualifying event and is still a qualified beneficiary at the time of the second event; and

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(5) The individual meets any applicable COBRA notice requirement in connection with a second event, such as notifying the Plan Administrator of a divorce or a child ceasing to be a dependent under the plan within 60 days after the event.

If all conditions associated with a second qualifying event are met, the period of continuation coverage for the affected qualified beneficiary (or beneficiaries) is extended from 18 months (or 29 months) to 36 months.

18 to 36-Month Period (Special Rule): A special rule for dependents provides that if a covered employee becomes entitled to Medicare benefits (either Part A or Part B) before experiencing a qualifying event that is a termination of employment or a reduction of employment hours, the period of coverage for the employee's spouse and dependent children ends with the later of the 36-month period that begins on the date the covered employee became entitled to Medicare, or the 18- or 29-month period that begins on the date of the covered employee's termination of employment or reduction of employment hours. (Note that under this special rule, the employee's Medicare entitlement is not a qualifying event because it does not result in loss of coverage for the employee's dependents; thus, the 36-month coverage period would be part regular plan coverage and part continuation coverage.)

Although an employee or eligible dependent may elect to continue coverage as outlined above, this period may be reduced because of any of the following events: The employer no longer provides group health coverage to any of its employees;

The premium is not paid within the 45-day grace period following the election of COBRA continuation coverage;

The premium for your continuation coverage is not paid; (the premium is due on the first of each month and will not be accepted after the thirtieth calendar day after the due date);

You become an employee covered under another group health plan (the Covered Person may be able to maintain continuation of coverage if there is a pre-existing condition clause that would limit your coverage under the other group plan); However, if other group health coverage is obtained prior to the COBRA election, COBRA coverage may not be discontinued, even if the other coverage continues after the COBRA election.

You or a covered dependent becomes entitled to Medicare after the COBRA election. However, if Medicare is obtained prior to COBRA election, COBRA coverage may not be discontinued, even if the other coverage continues after the COBRA election.

Additional information can be found regarding COBRA provisions for public-sector employees at www.cms.hhs.gov/ (The Center for Medicare and Medicaid Services).

You were divorced from a covered employee and subsequently remarry, and are covered under your new spouse’s group health plan.

If an employee or covered dependent elects to continue coverage on a self-pay basis, they may do so without proving insurability. However, if the election is not made within 60 days, health care coverage under the Plan will terminate retroactively to the day of the qualifying event. Further if the eligible employee or eligible dependent fails to make the initial COBRA continuation coverage premium payment within the 45-day grace period following the election of COBRA coverage they will be deemed ineligible for COBRA continuation coverage.

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http://www.cms.hhs.gov/

NOTE: Payment will not be considered made if a check is returned for non-sufficient funds.

The Plan Administrator reserves the right to terminate Plan coverage retroactively to the date the employee or covered dependent lost their eligibility under the terms of the employer-sponsored health care plan. This section of the Summary Plan Description is a summary of a very complicated law. In the event of any inconsistency between this Notice and federal law, federal law will take precedence.

Special Additional Continuation Coverage Election Period for “TAA-Eligible Individuals” In addition to the other COBRA rules described above, there are some special rules that apply if you are classified as a “TAA-eligible individual” by the U.S. Department of Labor. (This applies only if you qualify for assistance under the Trade Adjustment Assistance Reform Act of 2002 because you become unemployed as a result of increased imports or the shifting of production to other countries.) The Plan Administrator will require documentation evidencing eligibility of TAA benefits, including but not limited to, a government certificate of TAA eligibility, federal income tax filings, etc. The plan need not require every available document to establish evidence of TAA eligibility. You will be responsible for providing evidence of TAA eligibility when applying for coverage under the plan. The plan will not be required to assist you in gathering such evidence.

If you are classified by the Department of Labor as a TAA-eligible individual, and you do not elect continuation coverage when you first lose coverage, you may qualify for an election period that begins on the first day of the month in which you become a TAA-eligible individual and lasts up to 60 days. However, in no event can this election period last later than 6 months after the date of your TAA-related loss of coverage. If you elect continuation coverage during this special election period, your continuation coverage would begin at the beginning of that election period, but, for purposes of the required coverage periods described in this notice, your coverage period will be measured from the date of your TAA-related loss of coverage.

The Trade Adjustment Assistance Act also provides for a tax credit that may apply to some of your expenses for continuation coverage. You should consult with a financial advisor if you have questions about the tax credit.

TAA Coverage and HIPAA Creditable CoverageIf you are a TAA-eligible individual who elects COBRA after becoming TAA eligible, the period beginning on the date of the TAA-related loss of coverage and ending on the first day of the TAA-related election period will be disregarded for purposes of determining the 63-day break-in-coverage period pursuant to HIPAA rules regarding determination of prior creditable coverage for application to the plan’s pre-existing condition provision.

Applicable Premium PaymentsPayments of any portion of the applicable COBRA premium by the federal government on behalf of a TAA-eligible individual pursuant to TAA will be treated as a payment to the plan. Where the balance of any premium owed the plan by such individual is determined to be significantly less than the required applicable premium, as explained in IRS regulations 54.4980B-8, A-5 (b), the plan will notify such individual of the deficient payment and permit 30 days to make full payment. Otherwise the plan will return such deficient payment to the individual and coverage will terminate as of the original premium due date.

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If You Have QuestionsIf you have questions about your COBRA coverage, you should contact The COBRA Administrator or you may contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA). Addresses and phone numbers of Regional and District EBSA Offices are available through the EBSA’s website at www.dol.gov/ebsa.

Keep Your Plan Informed of Address ChangesIn order to protect your family’s rights, you should keep the Plan Administrator informed of any changes in the address of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator.

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http://www.dol.gov/ebsa

DEFINED TERMS

Accidental Injury – Unforeseen and unintended injury.

Ambulatory Surgical Center – A licensed facility that is used mainly for performing Outpatient surgery, has a staff of physicians, has continuous physician and nursing care by registered nurses (R.N.s) and does not provide for overnight stays.

Birthing Center – Any freestanding health facility, place, professional office or institution which is not a Hospital or in a Hospital, where births occur in a home-like atmosphere. This facility must be licensed and operated in accordance with the laws pertaining to Birthing Centers in the jurisdiction where the facility is located.

The Birthing Center must provide facilities for obstetrical delivery and short-term recovery after delivery (no more than 24 hours); provide care under the full-time supervision of a physician and either a registered nurse (R.N.) or a licensed nurse-midwife; and have a written agreement with a Hospital in the same locality for immediate acceptance of patients who develop complications or require pre- or post-delivery confinement.

Biofeedback – Provides training to help an individual gain some element of voluntary control over autonomic body functions.

Chiropractic Services – The detection and correction, by manual or mechanical means, of the interference with nerve transmissions and expressions resulting from distortion, misalignment or dislocation of the spinal (vertebrae) column.

COBRA – Means the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended.

Company – The Company is Capron Company, Inc., and any affiliates who have adopted the Plan.

Cosmetic Surgery – Medically unnecessary surgical procedures, usually, but not limited to, plastic surgery directed toward preserving beauty or correcting scars, burns or disfigurements.

Covered Expenses – Those expenses charged by a covered provider and medically necessary for the treatment of illness or injury.

Covered Person – An employee or dependent covered under this Plan.

Custodial Care – Care (including room and board needed to provide that care) that is given principally for personal hygiene or for assistance in daily activities and can, according to generally accepted medical standards, be performed by persons who have no medical training. Examples of Custodial Care are help in walking and getting out of bed; assistance in bathing, dressing, feeding; or supervision over medication which could normally be self-administered.

Durable Medical Equipment – Equipment which (a) Can withstand repeated use, (b) Is primarily and customarily used to serve a medical purpose, (c) Generally is not useful to a person in the absence of an illness or injury and (d) Is appropriate for use in the home.

Employee – A person directly employed in the regular business of, and compensated for services by Capron Company, Inc. on a regularly scheduled, full-time basis, and regularly scheduled to work for the Employer in an Employee/Employer relationship.

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Enrollment Date – First day of coverage, or first day of waiting period if there is a waiting period.

ERISA – The Employee Retirement Income Security Act of 1974, as amended.

Experimental/Investigational – Any treatment, procedure, facility, equipment, drugs, drug usage or supplies that are not recognized by the national board of the appropriate medical specialty as a generally accepted course of treatment for the medical condition being treated or which is performed for research or educational purposes or which has not been approved by a federal or state agency having jurisdiction and authority to approve such treatment, procedure, facility, equipment, drug or supplies.

The Plan Administrator must make an independent evaluation of the experimental/non-experimental standings of specific technologies. The Plan Administrator shall be guided by a reasonable interpretation of Plan provisions. The decisions shall be made in good faith and rendered following a detailed factual background investigation of the claim and the proposed treatment. The Plan Administrator will be guided by the following principles:1. If the drug or device cannot be lawfully marketed without approval of the U.S. Food

and Drug Administration and approval for marketing has not been given at the time the drug or device is furnished;

2. If the drug, device, medical treatment or procedure, or the patient informed consent document utilized with the drug, device, treatment or procedure, was reviewed and approved by the treating facility's Institutional Review Board or other body serving a similar function, or if federal law requires such review or approval;

3. If Reliable Evidence shows that the drug, device, medical treatment or procedure is the subject of on-going phase I or phase II clinical trials, is the research, experimental, study or investigational arm of on-going phase III clinical trials, or is otherwise under study to determine its maximum tolerated dose, its toxicity, its safety, its efficacy or its efficacy as compared with a standard means of treatment or diagnosis; or

4. If Reliable Evidence shows that the prevailing opinion among experts regarding the drug, device, medical treatment or procedure is that further studies or clinical trials are necessary to determine its maximum tolerated dose, its toxicity, its safety, its efficacy or its efficacy as compared with a standard means of treatment or diagnosis.

Reliable Evidence shall mean only published reports and articles in the authoritative medical and scientific literature; the written protocol or protocols used by the treating facility or the protocol(s) of another facility studying substantially the same drug, device, medical treatment or procedure; or the written informed consent used by the treating facility or by another facility studying substantially the same drug, device, medical treatment or procedure.

Extended Care Facility, Skilled Nursing Facility – Any or all of these facilities shall mean an institution which is licensed pursuant to state and local laws and is operated primarily for the purpose of providing skilled nursing care, rehabilitation and treatment for individuals convalescing from an injury or illness. These services shall be under the supervision of a physician and/or registered graduate nurse while providing 24 hours per day of nursing services.

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Generic Drug – A prescription drug that has the equivalency of the brand name drug with the same use and metabolic disintegration. This Plan will consider as a Generic Drug any Food and Drug Administration-approved generic pharmaceutical dispensed according to the professional standards of a licensed pharmacist and clearly designated by the pharmacist as being generic.

Hospice Agency – An agency where its main function is to provide hospice care services and supplies and it is licensed by the state in which it is located, if licensing is required.

Hospice Care Plan – A plan of terminal patient care that is established and conducted by a Hospice Agency and supervised by a physician.

Hospice Care Services and Supplies – Are those provided through a Hospice Agency and under a Hospice Care Plan and include Inpatient care in a Hospice Unit or other licensed facility, home care, and family counseling during the bereavement period.

Hospice Unit – A facility or separate Hospital Unit, that provides treatment under a Hospice Care Plan and admits at least two unrelated persons who are expected to die within six months.

Hospital – Is an institution which is engaged primarily in providing medical care and treatment of sick and injured persons on an Inpatient basis at the patient's expense and which fully meets these tests: it is accredited as a Hospital by the Joint Commission on Accreditation of Healthcare Organizations; it is approved by Medicare as a Hospital; it maintains diagnostic and therapeutic facilities on the premises for surgical and medical diagnosis and treatment of sick and injured persons by or under the supervision of a staff of physicians; it continuously provides on the premises 24-hour-a-day nursing services by or under the supervision of registered nurses (R.N.s); and it is operated continuously with organized facilities for operative surgery on the premises.The definition of "Hospital" shall be expanded to include the following: A facility operating legally as a psychiatric Hospital or residential treatment facility

for mental health and licensed as such by the state in which the facility operates. A facility operating primarily for the treatment of Substance Abuse if it meets these

tests: maintains permanent and full-time facilities for bed care and full-time confinement of at least 15 resident patients; has a physician in regular attendance; continuously provides 24-hour-a-day nursing service by a registered nurse (R.N.); has a full-time psychiatrist or psychologist on the staff; and is primarily engaged in providing diagnostic and therapeutic services and facilities for treatment of Substance Abuse.

Illness – Sickness or disease, including pregnancy, mental/nervous disorders, alcoholism and substance abuse, requiring treatment by a physician.

Injury – Accidental physical injury caused by unexpected external means requiring treatment by a physician.

Intensive Care Unit – A separate, clearly designated service area which is maintained within a Hospital solely for the care and treatment of patients who are critically ill and or injured. This also includes what is referred to as a "coronary care unit" or an "acute care unit". It has: facilities for special nursing care not available in regular rooms and wards of the Hospital; special life saving equipment which is immediately available at all times; at

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least two beds for the accommodation of the critically ill; and at least one registered nurse (R.N.) in continuous and constant attendance 24 hours a day.

Lifetime – Refers to benefit maximums and limitations while covered under this Plan.

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Medical Care Facility – A Hospital, a facility that treats one or more specific ailments or any type of Skilled Nursing Facility.

Medical Emergency – Accidental injury or sudden onset of a medical condition for which failure to get immediate medical care could be life threatening, cause serious harm to bodily functions, or seriously damage a body organ or part with acute symptoms requiring immediate medical care, including, but not limited to, conditions as heart attacks, cardiovascular accidents, poisonings, loss of consciousness or respiration, convulsions or other such acute medical conditions.

Medically Necessary (Medical Necessity) – Care and treatment recommended or approved by a physician, which is consistent with the patient's condition and accepted standards of medical practice, medically proven to be effective treatment of the condition, not performed solely for the convenience of the patient or provider, not conducted for investigative, educational, experimental or research purposes, and is the most appropriate level of service that can be safely provided to the patient. The fact that a physician may prescribe, order, recommend, or approve a service does not, of itself, make it medically necessary or make the charge a covered expense, even though it is not specifically listed as an exclusion under this Plan.

Medicare – The program established by Title 1 of Public Law 89.97 (79 Stat. 291) as amended, entitled Health Insurance for the Aged Act, and which includes: Part A - Hospital Insurance Benefits for the Aged; Part B - Supplementary Medical Insurance Benefits for the aged.

Mental Disorder – Any disease or condition that is classified as a Mental Disorder in the current edition of International Classification of Diseases, published by the U.S. Department of Health and Human Services or is listed in the current edition of Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association.

Morbid Obesity – A diagnosed condition in which the body weight exceeds the medically recommended weight by either 100 pounds or is twice the medically recommended weight in the most recent Metropolitan Life Insurance Company tables for a person of the same height, age and mobility as the Covered Person.

No-Fault Auto Insurance – The basic reparations provision of a law providing for payments without determining fault in connection with automobile accidents.

Outpatient Care – Treatment including services, supplies and medicines provided and used at a Hospital under the direction of a physician to a person not admitted as a registered bed patient; or services rendered in a physician's office, laboratory or X-ray facility, an ambulatory surgical center, or the patient's home.

Partial Hospitalization – A medically necessary alternative to Inpatient hospitalization with continuous treatment for at least four hours, but not more than 12 hours, in any consecutive 24 hour period in a hospital or treatment center.

Pharmacy – A licensed establishment where covered prescription drugs are filled and dispensed by a pharmacist licensed under the laws of the state where he or she practices.

Physician – Physician shall mean a legally qualified and licensed Doctor of Medicine (M.D.), Doctor of Osteopathy (D.O.), Doctor of Chiropractic (D.C.), Doctor of Dentistry

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(D.M.D. or D.D.S.), Doctor of Podiatry (D.P.M.), Doctor of Ophthalmology or Optometry (O.D. or M.D.), or a licensed clinical psychologist, working under the supervision of a psychologist or psychiatrist who is practicing within the scope of his or her license. Coverage will not be provided if such a Physician is the Employee, the Employee's spouse, child, brother, sister, or parent of the Employee.

Preferred Provider Organization (PPO) – A network health plan offered by a managed care company that contracts with a selected group of hospitals and physicians (preferred providers) offering quality care. Utilization management techniques are applied to covered services. The Plan pays network providers on a fee-for-service basis, usually at discounted rates. The Plan is designed to provide financial incentives in the form of increased benefits to members utilizing preferred providers.

Pregnancy – Childbirth and conditions associated with pregnancy, including complications.

Prescription Drug – Any of the following: a drug or medicine which, under federal law, is required to bear the legend: "Caution: federal law prohibits dispensing without prescription"; injectable insulin; hypodermic needles or syringes, but only when dispensed upon a written prescription of a licensed physician. Such drug must be medically necessary in the treatment of a sickness or injury.

Qualified Medical Support Order – A court issued order, judgment, decree or settlement agreement requiring a non-custodial parent to provide medical coverage for his or her child who might not otherwise be eligible for coverage. A qualified order includes information regarding the Plan participant's name and address, the name of the "alternate recipient" (i.e., the child), a "reasonable description" of the type and scope of health coverage provided under the Plan, and the period of time to which the order applies.

Sickness/Illness – Disease or medical condition and pregnancy diagnosed and requiring treatment by a physician.

Spinal Manipulation/Chiropractic Care – Skeletal adjustments, manipulation or other treatment in connection with the detection and correction by manual or mechanical means of structural imbalance or subluxation in the human body. Such treatment is done by a physician to remove nerve interference resulting from, or related to, distortion, misalignment or subluxation of, or in, the vertebral column.

Substance Abuse – The condition caused by regular excessive compulsive drinking of alcohol and/or physical habitual dependence on drugs that results in a chronic disorder affecting physical health and/or personal or social functioning. This does not include dependence on tobacco and ordinary caffeine-containing drinks.

Temporomandibular Joint (TMJ) Syndrome – The treatment of jaw joint disorders including conditions of structures linking the jaw bone and skull and the complex of muscles, nerves and other tissues related to the temporomandibular joint. Care and treatment shall include, but are not limited to orthodontics, crowns, inlays, physical therapy and any appliance that is attached to or rests on the teeth.

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Total Disability – Employee's complete inability to perform any and every duty of his or her regular or customary occupation or similar occupation for which the employee is reasonable capable due to education and training, as a result of illness or injury, or a dependent's inability to perform the normal activities of a person of like age and sex who is in good health.

Treatment Center – A facility licensed as a psychiatric, alcohol or substance abuse treatment facility by the state in which it is located that provides a planned program of treatment for mental and nervous disorders, or alcohol or substance abuse based on a written plan established and supervised by a physician.

Usual, Customary, Reasonable (UCR) – "Usual" means the provider's most frequent charge for the service or treatment.

"Customary" means the charge made, for the same service in the same area, by other physicians or medical service providers with similar training and experience.

"Reasonable" means the medical care or supplies; usually given and the fee usually charged for the cases in that area.

Utilization Review Manager – Utilization Review Manager is a group designed to monitor your proposed Inpatient admissions and some surgical/diagnostic procedures (refer to Surgical Diagnostic Review provisions of this booklet and health plan identification card).

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GENERAL PROVISIONS

Administration – This plan of benefits is administered through the Human Resources Department of Capron Company, Inc. The Loomis Company has been retained to provide independent services in the area of claims processing.

Assignability – Amounts payable under the terms of this Plan may be directed by the covered employee or participating dependent to the physicians and hospitals providing care. Benefits may not, however, be assigned to anyone other than the provider of service without the approval of Capron Company, Inc.

Funding – The benefits outlined in this booklet are paid directly from the required employee contributions and the assets of the Company. The Company may purchase insurance to reimburse itself if claims paid during a Plan Year exceed expected total amounts, expected individual amounts, or both.

Plan Amendment or Termination – Capron Company, Inc. reserves the full, absolute and discretionary right to amend, modify, suspend, withdraw, discontinue or terminate the Health Care Plan in whole or in part at any time for any and all participants of the Plan by formal action taken by the Board of Directors, or by the execution of a written amendment by the Plan Sponsor. If the Plan is amended, modified, suspended, withdrawn, discontinued or terminated, covered employees and covered dependents will be entitled to benefits for claims incurred prior to the date of such action.

Medical Care Decision – The benefits under the Plan provide solely for the payment of certain health care expenses. All decisions regarding health care are solely the responsibility of each Covered Person in consultation with the health care providers selected. The Plan contains rules for determining the percentage of allowable health care expenses that will be reimbursed, and whether particular treatments or health care expenses are eligible for reimbursement. Any decision with respect to the level of health care reimbursements, or the coverage of a particular health care expense, may be disputed by the Covered Person in accordance with the Plan's claim procedures. Each Covered Person may use any source of care for health treatment and health coverage as selected, and neither the Plan nor the employer shall have any obligation for the cost or legal liability for the outcome of such care, or as a result of a decision by a Covered Person not to seek or obtain such care, other than the liability of the Plan for the payments of benefits as outlined herein.

Subrogation – If the Plan advances benefits, subject to a determination of legal liability as the result of another party's conduct for expenses incurred by any Covered Person, including spouses and dependents as third party beneficiaries of the Plan, the Plan has the right to be reimbursed through Subrogation out of a Covered Person’s recovery from the settlement or judgment against the third party causing an injury. Any Covered Person for whom benefits are advanced is obligated to reimburse the Plan from the first dollars recovered (whether by settlement or judgment from the person causing the injury). The Covered Persons under the Plan who receive advances of benefits on account of an injury caused by another must execute a reimbursement agreement at the time they first submit a claim. The signed reimbursement agreement indicates that the Covered Person agrees to promptly reimburse the Plan for benefits advanced out of any monies recovered against the person causing the injury or any other source as the result of judgment, settlement or otherwise. In addition, the Plan, in the name of the Covered Person, may sue the person causing the injury if the Covered Person does not file suit within a

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reasonable time, and shall have a lien on the Covered Person’s recovery. The Covered Person may be required to provide information and execute documents to secure the Plan’s right to subrogation, and the Covered Person will take no action that would prejudice the Plan’s right to subrogate. The Plan shall have no obligation to share the costs of, or pay any part of, the Covered Person’s attorney’s fee and costs incurred in obtaining any recovery against the person causing the injury. Failure to obtain any required documents prior to the payment of benefits will have no effect on the Plan’s right to subrogate.

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RIGHTS AND PROTECTIONS

As a Covered Person in this Plan, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all plan participants shall be entitled to:1. Examine, without charge, at the Plan administrator's office all plan documents,

including insurance contracts, collective bargaining agreements and copies of all documents filed by the Plan with the U.S. Department of Labor, such as detailed annual reports and plan descriptions.

2. Obtain copies of all plan documents and other plan information upon written request to the Plan administrator. The administrator may make a reasonable charge for the copies.

3. Receive a summary of the Plan's annual financial report. The Plan administrator is required by law to furnish each participant with a copy of this summary annual report, if requested.

4. Continue health care coverage for yourself, spouse or dependents if there is a loss of coverage under the Plan as a result of a qualifying event. You or your dependents may have to pay for such coverage. Review this summary plan description and the documents governing the plan or the rules governing your COBRA continuation coverage rights.

5. Reduction or elimination of exclusionary periods of coverage for preexisting conditions under your group health plan, if you have creditable coverage from another plan. You should be provided a certificate of creditable coverage, free of charge, from your group health plan or health insurance issuer when you lose coverage under the plan, when you become entitled to elect COBRA continuation coverage, when your COBRA continuation coverage ceases, if you request it before losing coverage, or if you request it up to 24 months after losing coverage. Without evidence of creditable coverage, you may be subject to the preexisting condition exclusion for 12 months (18 months for late enrollees) after your enrollment date.

In addition to creating rights for plan participants, ERISA imposes duties upon the people who are responsible for the operation of this plan. The people who operate your plan, called "fiduciaries" of the Plan, have a duty to do so prudently and in the interest of you and the other plan participants and beneficiaries.

No one, including your employer or any other person, may fire you or otherwise discrimi-nate against you in any way to prevent you from obtaining a welfare benefit or exercising your rights under ERISA.

If a claim for a welfare benefit is denied in whole or in part, you must receive a written explanation of the reason for the denial. You have the right to have the Plan review and reconsider your claim.

Under ERISA, there are steps a Covered Person can take to enforce the above rights. For instance, if a Covered Person requests information from the Plan and does not receive it within 30 days, they may file suit in a federal court. In such a case, the court may require the Plan administrator to provide the materials and pay up to $110 a day until the Covered Person receives the materials, unless the materials were not sent because of reasons beyond the control of the administrators. If anyone has a claim for benefits which is denied or ignored, in whole or in part, they may file suit in a state or federal court. If it

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should happen that plan fiduciaries misuse the Plan's money, or if anyone is discriminated against for asserting their rights, they may seek assistance from the U.S. Department of Labor, or file suit in a federal court. The court will decide who should pay court costs and legal fees. If the individual is successful, the court may order the persons sued to pay these costs and fees. If the individual loses, the court may order that person to pay these costs and fees, for example, if it finds the claim is frivolous. If there are any questions about the Plan, contact the Plan administrator.

If there are any questions about this statement or about ERISA rights, contact the nearest Area Office of the Pension and Welfare Benefits Administration, U.S. Department of Labor, Philadelphia Regional Office, Gateway Building, 3535 Market Street, Room M300, Philadelphia, PA 19104, (215) 596-1134, or the Division of Technical Assistance and Inquiries, Pension and Welfare Benefits Administration, U.S. Department of Labor, 200 Constitution Avenue, NW, Washington, D.C. 20210.

The Health Care Plan intends at all times to be in compliance with ERISA and other applicable governmental laws, statutes, regulations, or rules promulgated by any governing unit having appropriate jurisdiction. Administration of this Plan will be in compliance with any changes to such statutes, regulations or rules affecting these provisions.

No provision contained in this booklet nor any portion of the Health Care Plan shall confer upon any Capron Company, Inc. or participant or entity acting on behalf of, or in place of, the Capron Company, Inc. or participant any right or cause of action, either at law or in equity against the Plan Administrator, the Third Party Administrator, the Employer, or the Utilization Review Manager for the acts of any Hospital in which care is received, or for the acts of any physician, or other provider from whom services are received under this Plan.

LEGISLATIVE COMPLIANCEAll provisions of the Plan shall at all times be in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), ERISA and other applicable governmental laws, statutes, regulations, or rules promulgated by any governing unit having appropriate jurisdiction. The Plan Administrator shall administer the Plan accordingly, as well as complying with any changes to such statutes, regulations or rules affecting these provisions.

Pursuant to HIPAA, the Plan will at no time take into consideration any health status -related factors, (physical or mental illnesses, prior receipt of health care, prior medical history, genetic information, evidence of insurability, conditions arising out of acts of domestic violence, or disability) which exist in relation to a person who is eligible for coverage under the Plan for purposes of determining the initial or continued eligibility of coverage under the Plan, for determining the level of contribution to Plan funding, or to determine the level of benefits which will be made available to a person. All Plan participants will be given written notice of any material reduction in benefits provided by the plan within 60 days of the adoption of such material reduction.

No provision contained in this booklet nor any portion of the Plan shall give a Plan participant or entity acting on their behalf any right or cause of action, either at law or in equity against the Plan Administrator, the Third Party Administrator, the Plan Sponsor, or the Utilization Review Administrator for the acts of any Hospital where care is received, for the acts of any physician, or other provider from whom services are received and benefits are provided under this Plan.

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NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

We are required by law to maintain the privacy of your protected health information (PHI). We are obligated to provide you with a copy of this Notice of our legal duties and of our privacy practices with respect to PHI and we must abide by the terms of this Notice. We reserve the right to change the provisions of our Notice and make the new provisions effective for all PHI we maintain. If we make a material change to our Notice, we will mail a revised Notice to the address that we have on record for the policyholder.

If you have any questions or want additional information about this Notice or the policies and procedures described in this Notice, please contact the Plan Administrator.

Effective Date: This Notice of Privacy Practices became effective on April 14, 2004.

PRIMARY USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATIONPayment: We may use or disclose your PHI to pay claims for services provided to you and to fulfill our responsibilities for plan coverage and providing plan benefits. For example, we may disclose your PHI when a provider (doctor, Hospital, clinic, etc.) requests information regarding your eligibility for coverage under our health plan, or we may use your information to determine if a treatment that you received was medically necessary.

Health Care Operations: We may use or disclose your PHI to support our business functions. These functions include, but are not limited to: medical care, quality assessment and improvement, stop-loss insurance underwriting, business planning, and business development. For example, we may use or disclose your PHI: (i) To provide you with information about one of our health management programs; (ii) To respond to a customer service inquiry from you; or (iii) In connection with fraud and abuse detection and compliance programs.

Business Associates: We contract with individuals and entities (Business Associates) to perform various functions on our behalf or to provide certain types of services. To perform these functions or to provide their services, our Business Associates will receive, create, maintain, use, or disclose PHI, but only after we require the Business Associates to agree in writing to contract terms designed to appropriately safeguard your information. For example, we may disclose your PHI to a Business Associate to administer claims or to provide service support, utilization management, subrogation, or pharmacy benefit management.

Other Covered Entities: We may use or disclose your PHI to assist other covered entities in connection with payment activities and certain health care operations. For example, we may disclose or share your PHI with other insurance carriers in order to coordinate benefits, if you or your family members have coverage through another carrier.

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PERMITTED USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATIONPersonal Representatives: We may disclose PHI to the patient or the patient’s personal representative. A personal representative is a legal guardian, or a person designated by you to act on your behalf in making decisions related to your health care.

Public Health Activities: We may disclose PHI to report health information to public health authorities for the purpose of preventing or controlling disease, injury or disability.

Abuse or Neglect: If we believe you are the victim of abuse or neglect, we may disclose PHI to a government authority such as social services or protective services agency.

Health Oversight Activities: We may disclose PHI to a health oversight agency that oversees the health care system and is charged with responsibility for ensuring compliance.

Legal Proceedings: We may disclose PHI in the course of a judicial or administrative proceeding in response to legal order or other lawful process.

Law Enforcement Officials : We may disclose PHI to the police or other officials in compliance with a court order or subpoena.

Organ & Tissue Procurement: We may disclose PHI to organizations that facilitate organ, eye or tissue procurement, banking or transplantation.

Coroners: We may disclose PHI to a medical examiner as authorized by law.

Specialized Government Functions: We may use and disclose PHI when required to do so by units of the government with special functions such as the U.S. military or the U.S. Department of State.

Workers’ Compensation: We may disclose PHI as authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs.

Health & Safety: We may use and disclose PHI, if in good faith, we believe it is necessary to prevent or lessen a serious and imminent threat to the health & safety of a person or the public.

As Required by Law: We may use and disclose PHI when required to do so by any other law not already referred to in the preceding categories.

To the Plan Sponsor: We may disclose your PHI to the plan sponsors of the group health plan for purposes of plan administration.

Others Involved in Your Care: We may disclose your PHI known to a family member, relative or close personal friend that you identify. Such a use will be based on how involved the person is in your care. If you are not present or able to agree to these disclosures of your PHI, then, using our professional judgment, we may determine whether the disclosure is in your best interest.

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YOUR RIGHTS Right to Request a Restriction: You have the right to request a restriction on the PHI we use or disclose about you for claim payment or healthcare operations. We are not required to agree to any restriction that you may request. If we do agree to the restriction, we will comply with the restriction unless the information is needed to provide emergency treatment to you.

Right to Request Confidential Communications: If you believe that a disclosure of your PHI may endanger you, you may request that we communicate with you regarding your information in an alternative manner or at an alternative location. For example, you may ask that we only contact you at your work address or via your work e-mail.

Right to Inspect and Copy : You have the right to inspect and copy your PHI that is contained in a “designated record set.” A “designated record set” contains your medical and billing records, as well as other records that are used to make decisions about your health care benefits. However, you may not inspect or copy psychotherapy notes or certain other information that may be contained in a designated record set.

Right to Amend : If you believe that your PHI is incorrect or incomplete, you may request that we amend your information. In certain cases, we may deny your request for an amendment. For example, we may deny your request if the information you want to amend is not maintained by us, but by another entity.

Right of an Accounting : You have a right to an accounting of certain disclosures of your PHI that are made for reasons other than claim payment or health care operations. No accounting of disclosures is required for disclosures you authorized. You should know that most disclosures of your PHI will be for purposes of claim payment or health care operations, and, therefore, will not be subject to your right to an accounting.

Right to a Paper Copy of this Notice: You have the right to a paper copy of this Notice, even if you may have agreed to accept this Notice electronically.

COMPLAINTSYou may file a complaint with us by contacting the Privacy Officer for this Plan if you believe that we have violated your privacy rights.

You also may file a complaint with the Secretary of the U.S. Department of Health and Human Services. You may submit this complaint to:

Department of Health and Human Services200 Independence Avenue, S.W.

Room 509F HHH BuildingWashington, DC 20201

We will not penalize or in any other way retaliate against you for filing a complaint with the Secretary or with us.

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HIPAA SECURITY REGULATIONS We are required to: Implement administrative, physical, and technical standards that reasonably and

appropriately protect the confidentiality, integrity, and availability of electronic PHI; Ensure that the firewall required by the HIPAA privacy rule is supported by reasonable

and appropriate security measures; Ensure that any agent or subcontractor to whom the Plan Sponsor provides electronic

PHI agrees to implement reasonable and appropriate security measures; and Report to the Plan any security incident of which the Plan Sponsor becomes aware.

NO VERBAL MODIFICATIONS

The Covered Person shall not rely on any oral statement from any employee of The Loomis Company which modifies or otherwise affects the benefits, general limitations and exclusions, or other provisions of this Plan and increases, reduces, waives or voids any coverage or benefits under this Plan.

In addition, such oral statement shall not be used in the prosecution or defense of a claim under this Plan.

Any written or oral verification received from Capron Company, Inc. is based upon eligibility information and Plan benefits, which are subject to change. Therefore, any verification should not be interpreted as a guarantee of coverage or payment for any services rendered or otherwise provided to a participant.

MISSTATEMENTS

In the event of any misstatement of any fact(s) affecting coverage under the Plan, the true facts will be used to determine the proper coverage. Coverage means eligibility as well as the amount of any benefits herein.

This booklet is not a contract. It explains in non-technical language the essential features of your Employee Benefit Program. Contact the Human Resources Department if there are any questions concerning coverage.

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IMPORTANT FACTS

PLAN NAME Capron Company, Inc.Employee Benefits Plan

PLAN SPONSOR Capron Company, Inc.411 North Stonestreet AvenueRockville, MD 20850

EMPLOYER I.D. NUMBER 52-1047768

GROUP NUMBER FCAPR

PLAN NUMBER 501

TYPE OF PLAN Self-Funded Medical, Dental & Prescription Card Expense Plan

PLAN EFFECTIVE DATE June 1, 1993 (original plan effective date)

PLAN YEAR ENDS June 1st through May 31st

PLAN COSTS Paid by Employer and Employees

AGENT FOR LEGAL PROCESS Service of Legal Process may be made uponCapron Company, Inc.411 North Stonestreet AvenueRockville, MD 20850

BENEFIT SERVICES MANAGER The Loomis CompanyP.O. Box 7011Wyomissing, PA 19610-6011(610) 374-4040

UTILIZATION REVIEW MANAGER Hines & Associates115 E Highland AvenueElgin, IL 601201-888-826-5769

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ACCEPTANCESUMMARY PLAN DESCRIPTION

EXECUTION

It is agreed that the provisions set forth in this document and properly executed amendments will be the basis for the administration of Capron Company, Inc. Group Health Plan effective June 1, 2011.

On Behalf of Capron Company, Inc.

____________________________________Name and Title

____________________________________Date

Version 2011

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